Official PDF , 143 pages

Amina Denboba, Amer Hasan,

and Quentin Wodon, Editors

Early Childhood Education and Development in IndonesiaA N A S S E S S M E N T O F P O L I C I E S U S I N G S A B E R

A W O R L D B A N K S T U D Y

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Early Childhood Education and Development in Indonesia

A W O R L D B A N K S T U D Y

Early Childhood Education and Development in IndonesiaAn Assessment of Policies Using SABER

Amina Denboba, Amer Hasan, and Quentin Wodon, Editors

Early Childhood Education and Development in Indonesia • http://dx.doi.org/10.1596/978-1-4648-0646-9

© 2015 International Bank for Reconstruction and Development / The World Bank1818 H Street NW, Washington DC 20433Telephone: 202-473-1000; Internet: www.worldbank.org

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vEarly Childhood Education and Development in Indonesia • http://dx.doi.org/10.1596/978-1-4648-0646-9

Contents

Acknowledgments ixAbout the Contributors xiExecutive Summary xvAbbreviations xxiii

Chapter 1 Overview 1Introduction 1

Chapter 2 National SABER-ECD Assessment for Indonesia 5Abstract 5Introduction 5SABER-ECD Framework 8Policy Goal 1: Establishing an Enabling Environment 10Policy Goal 2: Implementing Widely 23Policy Goal 3: Monitoring and Assuring Quality 32Benchmarking 38Conclusion 40Notes 42

Chapter 3 Coverage of Interventions at the Provincial Level 43Abstract 43Introduction 43Framework and Data 44Coverage of Essential Interventions 47Coverage and Level of Economic Development 59Conclusion 62Note 62

Chapter 4 District-Level SABER-ECD Assessments 69Abstract 69Introduction 69Establishing an Enabling Environment 70

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Implementing Widely Policy Goal and Levers 78Monitoring and Assuring Quality Policy Goal and Levers 84Conclusion 88

Chapter 5 SABER-ECD Ratings for Indonesia in Comparative Perspective 93Abstract 93Introduction 93Ratings and Levels of Development 94Examples of International Best Practice 97Conclusion 103Note 104

References 109

Boxes1.1 Indonesia and Milestones of Progress in ECED 22.1 How the Education System Is Financed and Managed in

Indonesia’s Decentralized Setup 72.2 Checklist to Consider How Well Early Childhood Development

Is Promoted at the Country Level 102.3 Key Laws Governing Early Childhood Development in Indonesia 132.4 Current Government Spending on Early Childhood Education

and Development 192.5 How Much Would It Cost to Expand Access and Raise

the Quality of Early Childhood Education and Development Services for Three- to Six-Year-Olds? 21

2.6 Opportunities to Improve Access to Early Childhood Education and Development Services through the Village Law 23

3.1 Essential Early Childhood Development Interventions Have High Returns 46

FiguresES.1 Three Core Early Childhood Development Policy Goals xviES.2 SABER-ECD Ratings for Indonesia and Other Countries xviiES.3 Essential Early Childhood Development Interventions xviiiES.4 Coverage of Essential Early Childhood Development

Interventions, 2012 xixB2.1.1 Financing Responsibilities under Decentralized Education

Management 7B2.1.2 Composition of Public Education Spending, 2009 82.1 Three Core ECD Policy Goals 92.2 Intersectoral Coordination in Indonesia 15

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Contents vii


B2.4.1 Central Government Spending on Early Childhood Education and Development, 2008–13 19

B2.5.1 Estimated Costs of Meeting Enrollment Targets for Three- to Six-Year-Olds with Early Childhood Education and Development Services That Satisfy the Minimum Service Standards 22

2.3 Essential Interventions during Different Periods of Young Children’s Development 24

2.4 Scope of Early Childhood Development Interventions in Indonesia, by Sector and Target Population 25

2.5 Disparities between Bottom and Top Quintiles of Wealth 312.6 Disparities between Urban and Rural Areas 313.1 Essential Interventions for Young Children 443.2 Coverage of Essential Early Childhood Development

Interventions, 2012 573.3 Change in Coverage over Time (2002–12, Unless Indicated

Otherwise) 583.4 Coverage of Early Childhood Development Interventions and

Economic Development 603.5 Changes in Coverage of Early Childhood Development

Intervention and Change in Economic Development (2002–12, Unless Indicated Otherwise) 61

4.1 Ratings for Enabling Environment Policy Goals 714.2 Ratings for Legal Framework Policy Levers 724.3 Ratings for Intersectoral Coordination Policy Lever 744.4 Ratings for Finance Policy Levers 764.5 Ratings in Implementing Widely Policy Goal 794.6 Scope of Programs in Pacitan District 804.7 Ratings for Scope of Program Policy Lever 814.8 Ratings for Coverage of Programs Policy Lever 824.9 Ratings for Equity Policy Lever 834.10 Ratings for Monitoring and Assuring Quality Policy Goal 844.11 Ratings for Data Availability Policy Lever 854.12 Ratings for Quality Standards Policy Lever 864.13 Ratings for Compliance with Standards Policy Lever 875.1 Ratings in Policy Goals and Level of Development 95A5.1 Ratings in Policy Levers and Level of Development 105

TablesES.1 Comparative Performance of Indonesia for SABER-ECD

Goals and Levers xviES.2 Policy Options to Strengthen ECD in Indonesia xx2.1 Snapshot of Early Childhood Development Indicators in

Indonesia with Regional Comparison 6

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2.2 ECD Policy Goals and Levels of Development 92.3 Regional Comparison of Maternity and Paternity Leave Policies 122.4 Early Childhood Development Budget across Sectors in

Indonesia, 2013 182.5 Regional Comparison of Selected Health Expenditure Indicators 202.6 Early Childhood Development Programs and

Coverage in Indonesia 262.7 Access to Essential Health Services for Young Children

and Pregnant Women 272.8 Access to Essential Nutrition Services for Young Children

and Pregnant Women 282.9 Regional Comparison of Level of Access to Birth Registration 292.10 Availability of Data to Monitor Early Childhood Development

in Indonesia 342.11 Benchmarking Early Childhood Development Policy in Indonesia 382.12 Comparison of Indonesia Ratings with Selected Other Countries 392.13 Comparing Early Childhood Development Policies with

Outcomes in Indonesia 392.14 Summary of Policy Options to Improve Early Childhood

Development Policy Development in Indonesia 413.1 Data Availability on Essential Interventions 463.2 Coverage of Interventions in the Family Support Package 503.3 Coverage of Interventions in the Pregnancy and Birth Packages 523.4 Coverage of Child Health and Development Interventions 543.5 Coverage of Education Interventions 563A.1 Description of Indicators Used to Measure Coverage 63A.2 Relation between Coverage Levels and Economic Development 66A.3 Relation between Change in Coverage Levels and Change in

Economic Development 674.1 Basic Statistics at Provincial Level 704.2 Enabling Environment Policy Goal and Levers 714.3 Implementing Widely Policy Goal and Levers 784.4 Coverage of Selected Early Childhood Development Programs

by District 824.5 Benchmarking the Monitoring and Quality Policy Goals 844.6 Comparison of District Ratings 894.7 Summary of Policy Options to Improve ECD Implementation

at the District Level 905.1 Comparative Performance of Indonesia for SABER-ECD

Goals and Levers 945.2 Relation between Policy Goals, Policy Levers, and Level of

Development 96

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ixEarly Childhood Education and Development in Indonesia • http://dx.doi.org/10.1596/978-1-4648-0646-9

This research received generous support from the Dutch Education Support Program trust fund (TF057272), the SABER umbrella trust fund managed by the Education Global Practice at the World Bank, and the Global Partnership for Education. The opinions expressed in the study are those of the individual authors only and need not represent those of the World Bank, its Executive Directors, or the countries they represent. This study benefited from substan-tial guidance from the Education Global Practice management, including Luis Benveniste (Practice Manager), Harry Patrinos (Practice Manager), Amit Dar (Director), and Claudia Costin (Senior Director).

The team expresses their sincere gratitude to the government of Indonesia for its support:

• NinaSardjunani,DeputyofHumanResourceandCulture,MinistryofNa-tional Development Planning

• Subandi,DirectorofEducation,MinistryofNationalDevelopmentPlanning• SiswantoRoesyidi,DeputyofPeople’sWelfare,SecretaryofCabinet• NugaanYuliaWardhaniSiregar,DirectorofTeacherandEducationPerson-

nel for Early Childhood Education and Development, Ministry of Education and Culture

• Burhanuddin,DirectorofToddler-FamilyGroupandChildren,NationalPop-ulation and Family Planning Agency

• Sukiman,HeadofSub-DirectorateProgramandEvaluation,MinistryofEdu-cation and Culture

• TheresiaSandraDyahRatih,HeadofSub-DirectorateImmunization,Minis-try of Health

• PutiChairidaAnwar,HeadofSub-DirectorateChildrenSocialWelfare,Min-istry of Social Affairs

• DwinitaYoenus, Head of Learning Program, Sub-Directorate Student andLearning, Ministry of Education and Culture

• Sudadi,HeadofSectionProgram,Sub-DirectorateProgramandEvaluation,Ministry of Education and Culture

Acknowledgments

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x Acknowledgments


• Ina Nurohmah, Directorate General of Early Childhood Education andDevelopment, Ministry of Education and Culture

• ValentinusSudarjanto,DirectorateGeneralofVillageCommunityEmpower-ment, Ministry of Home Affairs.

The team also acknowledges the local governments of Sukabumi District, Pacitan District, Sumbawa District, Kapuas District, and Manggarai Timur District for their support and feedback during the district-level study:

• DistrictPlanningandDevelopmentAgency• DistrictEducationOffice• DistrictHealthOffice• DistrictSocialAffairs• DistrictCommunityEmpowermentandVillageGovernance• DistrictReligiousAffairsOffice• FamilyPlanningandWomenEmpowermentAgency.

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xiEarly Childhood Education and Development in Indonesia • http://dx.doi.org/10.1596/978-1-4648-0646-9

About the Contributors

Lindsay Adams has been working on social development issues for 10 years. She is currently a consultant at the World Bank and focuses on early childhood devel-opment. She works in the World Bank’s Global Education and Knowledge Group in the Education Global Practice and has authored a number of Systems Approach for Better Education Results-Early Childhood Development (SABER-ECD) reports. Lindsay contributed to an evaluation of the Global Partnership for Education conducted by Results for Development. Prior to working on ECD, she worked at foundations promoting social development and human rights in the Middle East.

Amina Denboba is an early childhood development specialist with the Education Global Practice of the World Bank, with several years of experience in interna-tional development. Prior to that she worked at the American Institutes for Research where she managed School Health and Nutrition programs in Sub-Saharan Africa through operational and technical support to in-country School Health and Nutrition program implementers. Her experience covers research, policy dialogue, project design and implementation, and program management. She is an author of Stepping Up Early Childhood Development: Investing in Young Children for High Returns (2014) and several publications under the World Bank flagship program SABER. She holds an MA in international economics from the University of Pierre Mendes France in Grenoble, France, and a BA in economics and applied management from the University of Jean Moulin in Lyon, France.

Titie Hadiyati has been working in the field of early childhood education and development (ECED) since 1998. She has worked closely with colleagues in the Directorate in implementing the ECD-1 and ECED programs under the existing and newly established regulations on early childhood education. Her area of expertise includes community-based ECED service provision, among others. As a project management specialist, she was co-task team leader for the Early Childhood Education and Development Project and one of the task team leaders for the Regional Development Project at the World Bank in Indonesia.

Djoko Hartono is a monitoring and evaluation (M&E) specialist with more than 10 years of experience in directly managing M&E of various development

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xii About the Contributors


projects in Indonesia. He holds a PhD in demography from Australia National University. He joined the World Bank’s Jakarta Office in 2006 as an M&E spe-cialist in education programs. He currently works as an M&E specialist in the World Bank’s PNPM Generasi program. Before joining the World Bank, he was a researcher at the Indonesia Institute of Sciences (LIPI) with a major focus on policy research in the area of population and human development. Since 2012, he has been a research associate for a LIPI research project on maternal and child health among disadvantaged migrants residing in urban slums in several cities in Indonesia.

Amer Hasan is an economist with the Education Global Practice of the World Bank. He is a team leader for the impact evaluation of the Indonesia Early Childhood Education and Development project, a government program to expand access to pre school services in rural areas. His current work focuses on Indonesia and China and ranges from early childhood education to technical and vocational education and training. He holds a PhD and a master’s degree in pub-lic policy from the University of Chicago as well as a BA in history from Yale University.

Janice Heejin Kim has been working on education and social development issues for seven years. She is currently a consultant at the Global Education and Knowledge Group in the Education Global Practice at the World Bank, focusing on early childhood development. Before joining the Bank, she worked at the Organization for Economic Cooperation and Development (OECD) and has authored the Starting Strong III—A Quality Toolbox for Early Childhood Education and Care and a number of country reports on early childhood education system in OECD countries.

Mayla Safuro Lestari Putri received a degree in economics from Universitas Gadjah Mada. She currently works as research analyst at the World Bank for early childhood education and development programs in Indonesia. Her expertise is in unified database management, survey development, and policy mapping. In col-laboration with ministerial and district officers, she was one of two principal interviewers conducting SABER-ECD to understand the policy environment around early childhood education and development in Indonesia. Her research interests include survey and population analysis of education, health, and social welfare problems using longitudinal data such as the National Socioeconomic Survey (Survei Sosial Ekonomi Nasional, SUSENAS) and the Indonesian Family Life Survey.

Rosfita Roesli is a senior education specialist with the Education Global Practice based in the World Bank’s Jakarta Office. She was one of the task team leaders of the Indonesia Early Childhood Education and Development Project. She holds a master of arts degree in development studies from the University of Leeds, United Kingdom.

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About the Contributors xiii


Rebecca Sayre is an early childhood development and education specialist with professional experience in Africa, Latin America, and the United States. She pre-viously served as a core team member of the World Bank’s SABER-ECD initiative in Washington, DC. She has co-authored numerous publications, includ-ing Investing in Early Childhood Development: Review of the World Bank’s Recent Experience (2014) and Stepping Up Early Childhood Development: Investing in Young Children for High Returns (2014). She has consulted for the Brookings Center for Universal Education, Results for Development Institute, UNICEF, and Centro de Investigación y Docencia Económica. Rebecca’s two-year position as a Peace Corps volunteer in rural Peru sparked her personal and professional com-mitment to early childhood development in low-resource settings. Rebecca holds a BA in psychology, Spanish, and global and public health from the University of Virginia and an EdM in international education policy from the Harvard Graduate School of Education.

Quentin Wodon is a lead economist for education at the World Bank. Previously, he managed the World Bank unit on values and development, served as the lead poverty specialist for Africa, and as an economist/senior economist for Latin America. Before joining the World Bank, he was an assistant brand manager with Procter & Gamble, a volunteer corps member with the International Movement ATD Fourth World, and a tenured professor at the University of Namur. He has also taught at American University and Georgetown University. Quentin holds PhDs in economics and theology and religious studies. He has authored or coau-thored more than 450 publications and serves on various advisory boards, profes-sional association boards, and as associate editor for journals. He is actively involved with Rotary International and in pro bono consulting for nonprofits.

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xvEarly Childhood Education and Development in Indonesia • http://dx.doi.org/10.1596/978-1-4648-0646-9

Introduction

Since the early 2000s, Indonesia has taken a number of steps to prioritize early childhood development (ECD)—ranging from its inclusion of ECD in the National Education System Law No. 20 in 2003 to a Presidential Declaration on Holistic and Integrated ECD and the launch of the country’s first-ever ECD Census in 2011. These policy milestones have occurred in parallel with sustained progress on outcomes included in the Millennium Development Goals, for issues including child malnutrition, child mortality, and universal basic education. Additional progress could be achieved by strengthening ECD policies further. This report presents findings from an assessment of ECD policies and programs in Indonesia using two World Bank tools: the ECD module of the Systems Approach for Better Education Results (SABER) and the Stepping Up ECD guide on essential interventions for investing in young children. Results from the application of both tools to Indonesia are used to suggest a number of policy options to strengthen the Indonesian ECD system that policy makers and ECD practitioners should consider.

Assessment of ECD Policies

The assessment of ECD policies at the national and district level is based on the SABER-ECD diagnostic tool which is structured around three policy goals: establishing an enabling environment, implementing widely, and monitoring and assuring quality. For each policy goal, three policy levers are analyzed through which decision makers can strengthen ECD (figure ES.1).

The quality of policies at the level of goals or levers is rated on a four-point scale (latent, emerging, established, and advanced). At the national level, rat-ings obtained for Indonesia tend to be higher than those obtained by other countries for six of the policy levers (table ES.1 and figure ES.2), but they are below average for program coverage, equity, and compliance with standards.

• Establishing an enabling environment (established rating): Indonesia has enact-ed many key laws to ensure young children’s well-being. The Holistic and Integrated ECD Policy is an important step in ensuring coordination as the

Executive Summary

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xvi Executive Summary


country tries to expand access to and quality of essential ECD services. How-ever, funding for the sector may be insufficient.

• Implementing widely (emerging rating): The scope of ECD programs in Indonesia is generally broad, but could be expanded, particularly in parenting, preschool education and nutrition. Coverage rates for some services need improvement. Childhood malnutrition rates are high. Vast disparities in services and outcomes exist between wealthier and poorer families, as well as between families living in urban and rural locations. Children with special needs are unlikely to have access to appropriate services, despite policy goals to provide inclusive services.

• Monitoring and assuring quality (emerging rating): Indonesia collects a wide variety of administrative and survey data. The government has established many impor-tant ECD delivery and infrastructure standards. Some teachers do not meet qual-ifications, and only a small percentage of early childhood centers are accredited.

Establishing anenabling environment

Implementingwidely

Effe

ctiv

e EC

D p

olic

ies

Monitoring andassuring quality

Policy goals Policy levers Outcome

Intersectoral coordinationFinance

Scope of programs All children havethe opportunityto reach their full

potential

CoverageEquity

Data availabilityQuality standardsCompliance withstandards

Legal framework

Figure ES.1 Three Core Early Childhood Development Policy Goals

Source: Neuman and Devercelli 2013.

Table ES.1 Comparative Performance of Indonesia for SABER-ECD Goals and Levers

Goal 1: Enabling

environment

Goal 2: Implementing

widely

Goal 3: Ensuring quality

Lever 1: Legal

framework

Lever 2: Coordination mechanism

Lever 3: Finance

Indonesia 3 2 2.5 3 3 3

Average 2.1 2.4 2.1 2.4 1.9 2.1

Lever 4: Scope

of programs

Lever 5: Coverage of

programs

Lever 6: Equity in coverage

Lever 7: Data

availability

Lever 8: Quality

standards

Lever 9: Compliance

with standards

Indonesia 3 2 2 3 2.9 1.7

Average 2.5 2.6 2.3 2.1 2.5 1.6

Source: World Bank SABER-ECD Survey.Note: Each number indicates the level of development in ECD policy at the national level. “1” = latent, “2” = emerging, “3” = established, and “4” = advanced. Average indicates the average rating of 28 countries that have participated in the SABER-ECD Survey. SABER-ECD = Systems Approach for Better Education Results-Early Childhood Development.

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Executive Summary xvii


The SABER-ECD module was also piloted in five districts, given that the implementation of ECD policies has been decentralized at that level. Results from the tool reveal substantial differences across districts in the quality of ECD policies and programs. As expected, on average, across policy goals and levers, districts located in richer provinces tend to perform better than districts located in poorer provinces, but not on all dimensions. District-level strategies and insti-tutional anchors to coordinate service delivery across sectors are not always set up. While some districts have mandated universal coverage for some interven-tions, others have not. Many programs have limited coverage. To increase cover-age among vulnerable groups, higher budget allocations are required. The criteria for such allocations need to be refined. Data collection and analysis also needs to be improved, as does the ability to enforce compliance with standards to ensure quality.

Coverage of Essential ECD Interventions

When compared to other countries where the SABER-ECD module has been applied, Indonesia tends to perform less well in three areas: program coverage, equity, and compliance with standards. An analysis of the coverage of 25 essential ECD interventions confirms areas with low coverage, as well as major disparities between provinces. The 25 interventions are listed in figure ES.3 according to the type of intervention considered and the sector that implements them.

Data on the coverage of the interventions are provided in figure ES.4. Some services have high coverage across provinces (antenatal care, entry in primary school, and births attended by skilled personnel), but others have low coverage (enrollment in preprimary education, secondary school completion for moth-ers, and deworming medication). In addition, differences in coverage between

Figure ES.2 SABER-ECD Ratings for Indonesia and Other Countries

0

1

2

3

4

Lever 1:Legal

framework

Lever 2:Coordinationmechanism

Lever 3:Finance

Lever 4:Scope of

programs

Lever 5:Coverage of

programs

Lever 6:Equity incoverage

Lever 7:Data

availability

Lever 8:Quality

standards

Lever 9:Compliance

with standards

Indonesia Average

Source: Based on data in table ES.1.

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xviii Executive Summary


provinces are very large, often at 40–50 percentage points as shown in figure ES.4. In that figure, the diamond represents the national coverage level, and the bar represents the gap between the lowest and highest coverage rate at the level of provinces. When looking at trends over time, there have been gains in cover-age between 2002 and 2012, but again with large differences between prov-inces, as well as differences in gains depending on the interventions.

Policy OptionsOn the basis of the aforementioned diagnostic, a number of policy options could be considered at both the national and district levels to strengthen ECD policies and programs. While some of these options can be put into place fairly quickly, others, also critically important, will take more time. Therefore, as shown in table ES.2, policy options are classified into short- and medium-term options at the national level (N), district level (D), or both (N&D).

Figure ES.3 Essential Early Childhood Development Interventions

Birthregistration

Child protection services

Parental leave and adequate childcare

Continuity toquality primary

education

Early childhood and preprimary programs

Education about early stimulation, growth, and development

Matemal education

Hygiene/Handwashing

Adequate sanitation

Access to safe water

Prevention and treatment of parental depression

Access to healthcare

Planning for family size and spacing

Deworming

ImmunizationsAttendeddelivery

Antenatal visits

Iron-folic acidfor pregnant

monthers

Exclusivebreast

feeding

Complementary feeding Adequate, nutritious, and safe diet

Therapeutic zinc supplementation for diarrhea

Prevention and treatment for acute malnutrition (moderate and severe)

Micronutrients: supplementation and fortification

Counseling onadequate diet

during pregnancy

Pregnancy

Nutrition

Health

Water &sanitation

Education

Socialprotection

Birth 12 Months 24 Months 36 Months 54 Months 72 Months

Social assistance transfer programs

Source: Denboba et al. 2014.

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Executive Summary xix


Figure ES.4 Coverage of Essential Early Childhood Development Interventions, 2012

0 10 20 30 40 50 60 70 80 90 100

Antenatal care

Entry in primary school (ages 7−12 years)

Delivery attended by skilled personnel

Hand washing

Adequate treatment for children withacute respiratory infection

Immunization: DPT3

Vitamin A supplement for children

Use of any modern contraceptive method

Access to improved sanitation

Counseling on adequate diet for pregnant mothers

Breastfeeding within the first hour

Vitamin A supplement for pregnant mothers

Birth registration

Oral rehydration therapy for diarrhea

Access to improved drinking water

Adequate diet for children

Enrollment in preprimary education (ages 5−6 years)

Deworming medication for children

Female health insurance coverage by government

Female education (secondary completion)

Enrollment in preprimary education (ages 3−4 years)

Min Max National coverage level

Source: 2012 IDHS and SUSENAS surveys.Note: DPT = diphtheria, pertussis, and tetanus.

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xx Executive Summary


Table ES.2 Policy Options to Strengthen ECD in Indonesia

Short term (within 2 years) Level Medium term (3–5 years) Level

1. Establishing an enabling environment

Establish mechanisms for coordination between state and nonstate actors.

N&D Mandate attendance in preprimary education for children ages 3–6 years old.

N

Develop formulas for ECD budget allocations to improve targeting and transparency.

N&D Raise awareness among districts on the HI- ECD policy.

N

Track ECD expenditures multisectorally, particularly in child and social protection sectors.

N&D Extend maternity and paternity leave to allow greater flexibility in workforce participation and proper caregiving for infants.

N

Appoint a district-level institutional anchor or joint secretariat to coordinate ECD service delivery across sectors.

D Increase funding for early childhood care and education to ensure quality and access.

N&D

Improve collaboration between district offices to build HI ECD systems beyond education, including the health, nutrition, child and social protection sectors.

D Increase budget allocations to expand implementation of HI-ECD programs.

D

Strengthen effective communication between district offices through annual HI-ECD development planning.

D

2. Implementing widely

Use Village Law No. 6/2014 to encourage village governments to provide quality early childhood services through the village budget (Anggaran Dana Desa).

N&D Expand coverage of essential programs particularly those targeting disadvantaged children from poor families, rural or border areas and children with special needs. For example, initiate fee-free birth registration and provide low-cost services for disadvantaged children.

N&D

Incentivize villages to experiment with integrative services and encourage community participation in funding and service provision decisions.

N&D

Improve childhood immunizations requirement. N Ensure all pregnant women are covered in the new Jaminan Kesehatan Nasional insurance scheme. Maternal depression screening and treatment could help both mothers and children.

N

3. Monitoring and assuring quality

Track access to ECD programs and monitor child-level outcomes to identify children in need of additional support, particularly among vulnerable groups.

N&D Establish a one-source-data collection system for consistent use among district offices to help in the mapping of children and their needs at the district level.

D

Broaden access and enhance quality of in-service training (Diklat Berjenjang) and professional development opportunities for early child-hood educators, particularly in nonformal centers. Fee-free in-service training could be considered.

N&D Monitor individual child development outcomes as part of an early detection program (Stimulasi dan Intervensi Dini Tumbuh Kembang).

N&D

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Executive Summary xxi


Table ES.2 Policy Options to Strengthen ECD in Indonesia (continued)

Short term (within 2 years) Level Medium term (3–5 years) Level

Broaden training for village health workers (cadres and village midwives) to cover the links between early health and cognitive development.

N&D Increase minimum hours of attendance at centers to increase dosage.

N

Improve compliance with quality standards by enforcing established accreditation procedures for facilities

D

Develop a stronger role for ECD supervisors in quality assurance.

D

Note: N = national; D = district; N&D = both national and district; ECD = early childhood development; HI-ECD = Holistic Integrated-Early Childhood Development.

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xxiiiEarly Childhood Education and Development in Indonesia • http://dx.doi.org/10.1596/978-1-4648-0646-9

Abbreviations

ADD Anggaran Dana Desa

APBD Anggaran Pendapatan dan Belanja Daerah (Provincial or District

Government Budget)

BSNP Badan Standar Nasional Pendidikan (National Education Standards

Board)

DAU Dana Alokasi Umum (General Allocation Fund)

DHS Demographic and Health Survey

DPT diphtheria, pertussis, and tetanus

ECC Early Childhood Commission

ECCE early childhood care and education

ECD early childhood development

ECE early childhood education

ECED early childhood education and development

GoI government of Indonesia

HI-ECD Holistic Integrated-Early Childhood Development

HIV human immunodeficiency virus

IDR Indonesian rupiah

JKN Jaminan Kesehatan Nasional (national health insurance program)

MICS Multiple Indicator Cluster Survey

PNPM Program Nasional Pemberdayaan Masyarakat (National Program for

Community Empowerment)

PNS Pegawai Negeri Sipil (civil service)

PPP purchasing power parity

SABER Systems Approach for Better Education Results

UN United Nations

UNAIDS United Nations Programme on HIV and AIDS

UNESCO United Nations Educational, Scientific and Cultural Organization

UNICEF United Nations Children’s Fund

WHO World Health Organization

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1Early Childhood Education and Development in Indonesia • http://dx.doi.org/10.1596/978-1-4648-0646-9

Amina Denboba, Amer Hasan, and Quentin Wodon

C H A P T E R 1

Overview

Introduction

Investing in children in their early years represents a unique window of opportu-nity to improve individual, community, and societal outcomes. For poverty reduction and shared prosperity, investments in early childhood development (ECD) or early childhood education and development (ECED), to use the ter-minology used in Indonesia, are among the best investments that countries can make. When young children and their families have access to essential services in education, health, nutrition, sanitation, social protection, and water, they are afforded the opportunity to learn and lead healthy and productive lives. The returns to ECD interventions have been shown to be often larger than the returns for interventions later in life. Conversely, failing to invest early in life can lead to irreversible damage for the future.

Indonesia has benefitted from robust economic growth over the last decade. Nevertheless, more than 27 million people still live in poverty (12.2 percent of the population), and a larger number remain vulnerable. There are very large wealth disparities between the various islands that lead to differences in development outcomes, including for young children. The fact that Indonesia has the fourth largest population in the world with many different ethnic and linguistic groups also contributes to disparities in development outcomes within the country.

Since the early 2000s, Indonesia has taken a number of decisive steps to pri-oritize early childhood development—ranging from the inclusion of ECD in the National Education System Law No. 20 in 2003 to a Presidential Declaration on Holistic and Integrated Early Childhood Development to the launch of the coun-try’s first ever ECD Census in 2011. Box 1.1 presents some of the key milestones of progress in ECED that Indonesia has achieved. These policy milestones have occurred in parallel with sustained progress towards many of the Millennium Development Goals. For example, Indonesia has already met and surpassed pro-jected reductions in the number of underweight children younger than five years of age to less than 18 percent and is on track to meeting its targets for reducing overall child mortality and the targets for achieving universal basic education.

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2 Overview


Yet, according to 2010 census data, the number of children under six years of age is almost 32 million, making the needs for service delivery massive.

This study provides an assessment of ECD policies and programs in Indonesia based on the World Bank’s Systems Approach for Better Education Results (SABER). Developed by the Education Global Practice, SABER provides a set of diagnostic tools to assess country policies in a number of areas including ECD. The SABER-ECD tool employs a diagnostic framework structured around three policy goals: establishing an enabling environment, implementing widely, and monitoring and assuring quality. For each goal, three policy levers are analyzed,

Box 1.1 Indonesia and Milestones of Progress in ECED

For more than a decade, the government of Indonesia has implemented policies and programs

that prioritize the early years. The first critical step was taken in 2001, when a new directorate

dedicated to early childhood was established within the Ministry of Education and Culture. Its

early advocacy within and beyond the government influenced policy development, put ad-

ditional resources into community ECED services, and created strategies to raise Indonesian

awareness about the importance of the early years. The United Nations Children’s Fund (UNI-

CEF) initiated integrated health service clinics for mothers and children (Taman Posyandus) as

part of their Smart Toddler program (Balita Cerdas), one component of the government’s ini-

tiatives to support early childhood.

The second critical step was taken when early childhood education was included in a

succession of key policy documents: the National Education System Law No. 20 in 2003 and

the Ministry of Education and Culture’s Strategic Plan (Rencana Strategis or RENSTRA) in 2004.

In the context of these institutional and policy changes, a pilot project covering 12

districts, which had begun under the purview of the Directorate of Community Education,

was transferred to the supervision of the newly formed Directorate of Early Childhood Educa-

tion. The pilot project established new ECED services in poor villages. It previewed and pro-

vided key lessons that were subsequently incorporated into a larger-scale project initiated in

2006 covering 3,000 villages in 50 districts.

More recently, the need to consider ECED services holistically, across sectors and

developmental domains, was recognized through the government’s issuance of an ambi-

tious policy strategy and accompanying guidelines in 2008. The development of national

standards for ECED by the National Education Standards Board (BSNP) in 2009 situated

early childhood education as the foundation of the country’s education system.

A lingering barrier to coordinated ECED service provision was removed when the “formal”

and “nonformal” directorates were merged into one unit in 2010 with responsibility for all

ECED activities. Finally, the initiation of ECED censuses since 2011 has begun to provide

researchers and policy makers with essential data and should continue to inform future ECED

decisions.

Source: Hasan, Hyson, and Chang 2013.

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Overview 3


ranging from the legal framework for ECD services to the extent to which ser-vice providers such as care centers or preschools comply with national standards (Neuman and Devercelli 2013). Country policies are assessed along each of these dimensions. The SABER-ECD tool to a large extent focuses on policy intent, but as its name indicates, the second policy goal in the ECD module is about implementation. To this end, the analysis is complemented by a more detailed analysis of the coverage of essential interventions at the provincial level.

The study relies on administrative and household survey data in order to provide a diagnostic of policies and programs related to ECD in Indonesia. Administrative data are used to assess ECD policies and programs at the nation-al and district levels. The study consists of five chapters:

• Chapter2appliestheSABER-ECDframeworkatthenationallevel.Strength-ening ECD policies can be viewed as a continuum; for each policy goal and corresponding policy levers, a policy classification rubric comprising a range of indicators and subindicators is used to calculate levels of policy development. For each subindicator, a score of latent (1 point), emerging (2 points), estab-lished (3 points), or advanced (4 points) is allotted. Then, the indicator score is calculated from the average of subindicators. Finally, the level of policy develop-ment for each policy lever is calculated from the average of the indicator scores. The policy lever scores are then averaged to form a score for each policy goal.

• Building on the application of the SABER-ECD framework in Indonesia,both at the national and district levels, chapter 3 focuses on measuring in a more comprehensive way the coverage of essential ECD interventions na-tionally and at the provincial level. The list of interventions is based on a framework identifying 25 key programs for young children and their families. For 19 of 25 interventions, information is available in the nationally represen-tative household surveys, especially from the 2002, 2007, and 2012 Demo-graphic and Health Surveys (DHS), and the 2007 and 2012 SUSENAS sur-veys in the case of interventions for the preschool package.

• GiventhedecentralizationofmanyECDpoliciesandprogramsatthedis-trict level, chapter 4 provides results from the application of the SABER-ECD framework to five districts. While this represents only about 1 per-cent of all districts, the results are interesting to showcase differences in policies and programs between districts. As expected, on average across policy goals and corresponding policy levers, districts located in richer provinces tend to perform better than districts located in poorer provinces, but not on all dimensions.

• Chapter5comparestheSABER-ECDratingsobtainedforIndonesiawiththe ratings for other countries (in total, the tool has been implemented in about 28 countries so far). The chapter also provides illustrations of selected examples of best practice policies for all three policy goals and various dimensions from around the world that could potentially provide inspira-tion for improved policy development in Indonesia.

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Abstract

The Systems Approach for Better Education Results (SABER) produces comparative data and knowledge on education policies and institutions, with the aim of helping countries strengthen their education systems. In the case of Early Childhood Development (ECD—this will be the acronym used in this study even though the acronym used in Indonesia is early childhood education and devel-opment, or ECED), the focus is on early learning, health, nutrition, as well as social and child protection policies. SABER-ECD evaluates the quality of policies against evidence-based global standards, using a diagnostic tool and detailed policy data collected from administrative sources and in-depth key informant interviews. This chapter applies the SABER-ECD framework to Indonesia.

Introduction

As noted by Denboba et al. (2014), investing in children in their early years represents a unique window of opportunity to improve individual, community, and societal outcomes. For poverty reduction and shared prosperity, investments in early childhood development (ECD) are among the best investments that countries can make. When young children and their families have access to essential services in education, health, nutrition, sanitation, social protection, and water, they are afforded the opportunity to learn and lead healthy and produc-tive lives. The returns to ECD interventions have been shown to be often larger than the returns for interventions later in life. Conversely, failing to invest early in life can lead to irreversible damage for the future. Unfortunately, most coun-tries today fall short in their ECD investments.

Table 2.1 considers how Indonesia is investing in ECD and provides a snapshot of selected ECD outcome indicators in the country, with a comparison with selected other countries. The focus is on infant mortality, child mortality, stunting,

C H A P T E R 2

National SABER-ECD Assessment for IndonesiaLindsay Adams, Amina Denboba, Titie Hadiyati, Djoko Hartono, Amer Hasan, Janice Heejin Kim, Rosfita Roesli, Mayla Safuro, and Quentin Wodon

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6 National SABER-ECD Assessment for Indonesia


the enrollment rate in preschools, and the rate of birth registration. The data for Indonesia are provided circa 2012 using a United Nations Children’s Fund (UNICEF) database. Among the five countries in the table (China, India, Indonesia, the Philippines, and Vietnam), Indonesia tends to be second to last or last for all indicators, suggesting scope for improvement. To foster such improve-ments, the central government of Indonesia (GoI) issued a Holistic Integrated-Early Childhood Development policy (HI-ECD policy). The policy aims to pro-vide comprehensive and integrated ECD services to all children from birth to age six years. But while the policy lays out foundations for a strong ECD system, issues remain around coverage, equity, and quality of the services provided. Administratively, the country is organized into 33 provinces and a special admin-istrative region. Decentralization has been implemented since 2001, leading to a substantial degree of autonomy for subnational administrative units, including districts in the case of ECD programs and policies targeting young children. Box 2.1 provides an overview of the decentralized education system in Indonesia. The challenge of implementation is substantial, in part because of the size of the country. According to 2010 census data, the number of children younger than six years of age is at almost 32 million, making the needs for service delivery massive.

This chapter provides the results of the application of the SABER-ECD diag-nostic tool to Indonesia at the national level (chapter 4 considers the application of the tool at the district level). The structure of the chapter is as follows. This chapter describes the SABER-ECD framework. The next three chapters provide the results of the assessment including policy options to be considered for improved policy dialogue to strengthen each policy lever assessed. As is the case for other SABER modules, the SABER-ECD module is to a large extent focused on policy intent, but as its name indicates, the second policy goal in the ECD module is about imple-mentation. A more detailed analysis will be required to make tailored and context specific policy recommendations moving forward. A conclusion follows.

Table 2.1 Snapshot of Early Childhood Development Indicators in Indonesia with Regional Comparison

Indonesia China India Philippines Vietnam

Infant mortality (deaths per 1,000 live births, 2012) 26 12 44 24 18

Below -5 mortality (deaths per 1,000 live births, 2012) 31 14 56 30 23

Moderate and severe stunting (below 5, 2008–12) (%) 36 10 48 32 23

Gross preprimary enrollment ratea (5–6 years, 2011) (%) 46 62 58 — 72

Birth registration 2005–12 (%) 67 — 41 90 95

Source: UNICEF 2012.Note: — = not available.a. For gross preprimary enrollment rate, this chapter used data from the UNICEF–Multiple Indicator Cluster Survey. Chapters 1 and 3 used net preprimary enrollment rate data from the SUSENAS 2003–13.

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National SABER-ECD Assessment for Indonesia 7


Box 2.1 How the Education System Is Financed and Managed in Indonesia’s Decentralized Setup

The education system in Indonesia is a very large, highly decentralized system, with over 500

district governments playing a strong role in its management. While many ministries register

spending on education in their budgets, the Ministry of Education and Culture and the Ministry

of Religious Affairs are responsible for setting policies and managing the system. Under both

ministries, public and private provision coexist and receive public support in the form of civil

service teachers (at all levels) and direct school grants (in basic education). While the nine years

of basic education (primary and junior secondary) are compulsory and heavily subsidized,

household contributions are high in early childhood education services. This is partly because

of widespread private provision of kindergartens and limited public support for preschool.

Both central and district governments are responsible for developing and managing the

teaching force. Other central government agencies remain in charge of setting pay rates for

civil servants and transferring district government budgets.

The funding system for the education sector is complex, involving multiple sources and

transfers across various levels of government. Despite efforts to simplify budgets, schools still

receive funds from an array of budget sources: some come directly from the central govern-

ment and some from local governments (mainly districts).

Central government transfers are the main source of revenue for district government bud-

gets (APBD). The main transfer to subnational governments is the DAU block grant, which

provides funding for the salaries of district civil servants, including civil service (PNS) teachers.

District and provincial governments also receive funds from different transfer mechanisms,

each with specific associated incentives.

A constitutional amendment passed in 2002 establishes that at least 20 percent of the

total state budget has to be spent on education. Both central and local government budgets

are subject to the rule, which includes budget revisions. This rigidity creates significant distor-

tions in decision making.

box continues next page

Figure B2.1.1 Financing Responsibilities under Decentralized Education Management

Nationalpolicies,

standards, andMIS

Financing

Early

child

hood Central

Province

District

Regulatoryframework at

the provincial/district level

Curriculumdevelopmentat school level

Provision/service

delivery

Note: Boxes indicate relative role of each level in the activity indicated in the column. Each box represents 25 percent. MIS = management information system.

While education financing remains a shared responsibility between all levels of govern-

ment, the bulk of funds for pretertiary education are provided by district governments.

In 2001, the responsibility for many aspects of basic education was devolved to local

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Figure B2.1.2 Composition of Public Education Spending, 2009

26 22

41

100

16 3

16

7161

53

0

10

20

30

40

50

60

70

80

90

100

Early childhooddevelopment

Basic education Senior secondaryeducation

Universities

Perc

enta

ge

of to

tal s

pen

din

g

Central BOS - school grant Province District

Source: World Bank 2013.Note: Financing responsibilities in the figure reflect the main responsibilities under the education program assigned to a specific level of government. BOS = Biaya Operasi Sekolah (School Operation Fund).

Box 2.1 How the Education System Is Financed and Managed in Indonesia’s Decentralized Setup

SABER-ECD Framework

SABER-ECD collects, analyzes, and disseminates comprehensive information on ECD policies around the world. In each participating country, extensive multi-sectoral information is collected on ECD policies and programs through a desk review of available government documents, data and literature, and interviews with a range of ECD stakeholders, including government officials, service provid-ers, civil society, development partners, and scholars.

The SABER-ECD framework aims to provide a holistic and integrated assess-ment of how the overall policy environment in a country affects young children’s development. The tool identifies three core policy goals that countries should address to ensure optimal ECD outcomes: (1) establishing an enabling environ-ment, (2) implementing widely, and (3) monitoring and assuring quality. Improving

governments. Decentralization reforms were expected to lead to significant improvements in

education outcomes by bringing decision making closer to the parents and students that are

directly affected. In this way, decisions on the best way to deliver education services would be

increasingly responsive to local needs and more aligned with the specific characteristics of

each district. Decentralization was also expected to lead to greater innovation and experi-

mentation in service delivery with the potential for successful reforms to be replicated across

local governments. In 2009, approximately 71 percent of all public education spending on

ECED was provided by district governments (figure B2.1.2).

(continued)

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ECD requires an integrated approach to address all three goals. As described in figure 2.1, for each policy goal, a series of policy levers are identified, through which decision makers can strengthen ECD. Strengthening ECD policies can be viewed as a continuum; as described in table 2.2, countries can range from a latent

Figure 2.1 Three Core ECD Policy Goals

Establishing anenabling environment

Implementingwidely

Effe

ctiv

e EC

D p

olic

ies

Monitoring andassuring quality

Policy goals Policy levers Outcome

Intersectoral coordinationFinance

Scope of programs All children havethe opportunityto reach their full

potential

CoverageEquity

Data availabilityQuality standardsCompliance withstandards

Legal framework

Source: Neuman and Devercelli 2013.Note: ECD = early childhood development.

Table 2.2 ECD Policy Goals and Levels of Development

ECD policy goal

Level of development

Latent Emerging Established Advanced

Establishing an enabling environment

Nonexistent legal framework; ad-hoc financing; low intersectoral coordination.

Minimal legal framework; some programs with sustained financing; some intersectoral coordination.

Regulations in some sectors; functioning intersectoral coordination; sustained financing.

Developed legal framework; robust interinstitutional coordination; sustained financing.

Implementing widely

Low coverage; pilot programs in some sectors; high inequality in access and outcomes.

Coverage expanding but gaps remain; programs established in a few sectors; inequality in access and outcomes.

Near-universal coverage in some sectors; established programs in most sectors; low inequal-ity in access.

Universal coverage; comprehensive strat-egies across sectors; integrated services for all, some tailored and targeted.

Monitoring and assuring quality

Minimal survey data available; limited standards for provision of ECD services; no enforcement.

Information on outcomes at national level; standards for services exist in some sectors; no system to monitor compliance.

Information on outcomes at national, regional and local levels; standards for services exist for most sectors; system in place to regularly monitor compliance.

Information on outcomes from national to individual levels; standards exist for all sectors; system in place to regularly monitor and enforce compliance.

Source: Neuman and Devercelli 2013.Note: ECD = early childhood development.

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Box 2.2 Checklist to Consider How Well Early Childhood Development Is Promoted at the Country Level

Health Care− Standard health screenings for pregnant women

− Skilled attendants at delivery

− Childhood immunizations

− Well-child visits

Nutrition− Breastfeeding promotion

− Salt iodization

− Iron fortification

Early Learning− Parenting programs (during pregnancy, after delivery, and throughout early childhood)− High-quality childcare for working parents− Free preprimary school (preferably at least two years with developmentally appropriate curriculum

and classrooms, and quality assurance mechanisms)

Social Protection− Services for orphans and vulnerable children

− Policies to protect rights of children with special needs and promote their participation/access to ECD services

− Financial transfer mechanisms or income supports to reach the most vulnerable families (could include cash transfers, and social welfare)

Child Protection− Mandated birth registration

− Job protection and breastfeeding breaks for new mothers

− Specific provisions in judicial system for young children

− Guaranteed paid parental leave of at least six months

− Domestic violence laws and enforcement

− Tracking of child abuse (especially for young children)

− Training for law enforcement officers in regards to the particular needs of young children

Source: Adapted from Neuman and Devercelli 2013.Note: ECD = early childhood development.

to an advanced level of development within the different policy levers and goals. The assessment provided in this chapter can be used to identify how to think about policy challenges related to ECD. Box 2.2 presents an abbreviated list of interven-tions and policies that the SABER-ECD tool looks at in countries when assessing the level of ECD policy development. The list is not exhaustive, but is meant to provide an initial checklist to consider when thinking about policies across sectors.

Policy Goal 1: Establishing an Enabling Environment

An enabling environment is the foundation for the design and implementation of effective ECD policies (Brinkerhoff 2009; Britto, Yoshikawa, and Boller 2011; Vargas-Baron 2005). An enabling environment consists of the following:

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the existence of an adequate legal and regulatory framework to support ECD; coordination within sectors and across institutions to deliver services effec-tively; and sufficient fiscal resources with transparent and efficient allocation mechanisms.

Policy Lever 1.1: Legal Framework (Rating: Established)The legal framework comprises all of the laws and regulations which can affect the development of young children in a country. The laws and regulations that impact ECD are diverse because of the array of sectors that influence ECD and because of the different constituencies that ECD policy can and should target, including pregnant women, young children, parents, and caregivers. In Indonesia, national laws promote health care for pregnant women—this policy lever is rated as established, but could nevertheless be strengthened.

The new universal health care insurance system, the Jaminan Kesehatan Nasional (JKN), which has been recently established and is being expanded, is a step in that direction. Wealthier citizens pay premiums, and the government provides grants to cover premiums for poor individuals. Individuals must enroll, and the scheme will be rolled out over the next several years.

JKN covers individual care including promotion, preventive, curative, and rehabilitative health services with selected condition of facility. Since the JKN policy was issued in 2013, childbirth insurance scheme (Jaminan Persalinan, Jampersal) is no longer applied. However, all mother and child programs (Kesehatan Ibu dan Anak) that were previously covered in Jampersal are now being covered in the new scheme, for example antenatal and neonatal care, post-natal care, and institutional delivery.

Access to screening tests and health services, as well as referrals to services, is provided for free for women or mothers who voluntarily want to get tested or as suggested by medical staff. Screening for human immunodeficiency virus (HIV) in pregnant women is not required, but is recommended for women deemed at elevated risk. The government could however consider mandated screening for all pregnant women. According to United Nations Programme on HIV and AIDS (UNAIDS), approximately 610,000 Indonesians are living with HIV—a number which could include over 8,000 pregnant women in any given year.1 Without universal testing and treatment, HIV-positive pregnant women are at risk of pass-ing HIV to their babies. Screening would strengthen efforts to reduce HIV trans-mission under the Minister of Health Regulation on HIV/AIDS Prevention no. 21/2013 and Minister of Health Regulation No. 51/2013 on HIV/AIDS Prevention from Mother to Child.

Government policies and programs provide basic health care for children. The new national health insurance system covers well-child visits. According to the Act on Child Protection, the government must provide free basic health care and referral services for children from poor families. In addition, mother and child programs, such as antenatal care and growth and development monitoring, can be implemented at all health facilities, including Posyandu. Young children

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receive a mandatory course of immunizations, but the course does not include mumps, rubella, and meningitis vaccinations. The government could consider adding these immunizations to the mandatory course in order to provide the broadest possible protection for children’s health.

National laws and regulations promote appropriate dietary consumption by pregnant women and young children. The Government Regulation on Exclusive Breastfeeding and a health ministry decree establish the government’s support for exclusive breastfeeding until the age of six months. Mothers are guaranteed breastfeeding breaks and facilities in places of employment. Salt iodization is mandatory, as is fortification of flour with micronutrients.

Policies protect new parents and provide parents and caregivers opportuni-ties to care for newborns and infants, but parental leave could be extended (see table 2.3). Indonesian labor laws bar employment discrimination for pregnant women and mothers, and establishes job protection. Public and private sector workers receive 90 days of paid maternity leave, starting 1.5 months before the expected delivery. Fathers receive two days of paid pater-nity leave. The actual coverage of these benefits is often limited by the size of the formal sector in the economy. The GoI could consider ways of extend-ing maternity and paternity leave to promote labor participation and proper caregiving for infants. In addition, parental leave policies should be highly flexible to allow new parents provide the appropriate and timely care for their newborn. A baby’s need for caregiving, breastfeeding, and nurturing are greatest in the early months of life. Finding ways to extend the coverage of flexible parental leave could improve babies’ health and development outcomes, as well as the well-being of mothers, which in turn has a strong impact on their children’s well-being.

Indonesia lacks a strong policy to provide free preprimary education. Currently preprimary education is not compulsory. According to the Strategic Plan and Grand Design of ECE Development 2011–25 document issued by the Directorate General of Early Child Education, the target gross enrollment rate for early child-hood care and education (ECCE) in 2015 is 75 percent. The government is promoting enrollment through establishing and expanding nonformal ECCE

Table 2.3 Regional Comparison of Maternity and Paternity Leave Policies

Indonesia China Thailand Vietnam

Ninety days paid ma-ternity leave at 100 percent wage; 2 days paid paternity leave at 100 percent wage

Ninety days paid maternity leave at 100 percent wage; no national law ensur-ing paternity leave, although some local governments offer it

Forty-five days of paid maternity leave at 100 percent wage, up to 45 more days of unpaid leave, al-though some classes of workers are not entitled to any leave; no paternity leave

Four months (roughly 120 days) of maternity leave at 100 percent wage, with extensions for certain medical or working conditions; no paternity leave

Source: ILO Working Conditions Laws Database – Maternity Protection, 2012.

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centers and community-based groups. Government data for 2012 suggest that 162,748 centers are operating, but of those only 10,077 are accredited (the rest, a total of 152,671 centers, are not). Among the centers, only a small minority (3,789) are public, 132,269 are private (both for profit and nonprofit), and 26,690 are community based.

Birth registration is mandatory. The Child Protection Act states that a birth certificate establishes a child’s identity and is required upon birth. Birth cer-tificates are free and are issued by the government. Eight government minis-tries have signed a Memorandum of Understanding to accelerate the issuance of birth certificates.

A range of policies and services promote child protection. The Ministry of Women Empowerment and Child Protection is responsible for implementing child protection laws at the national level with district authorities charged with implementation at the local level. The government promotes the reduction of family violence through various programs, including training on identification of child abuse and neglect, child abuse tracking, violence prevention through home visits, and a taskforce for domestic violence prevention. It provides pro-tection, counseling, and legal advocacy for victims of family violence. And it trains judges, lawyers, and law enforcement officers on protecting children.

Social protection policies and services support vulnerable children and chil-dren with special needs. Several programs provide services for vulnerable chil-dren, including the Social Block Grant for Child Welfare Agencies, PKSA Balita (Children-Welfare Program for children younger than five years of age) and TAS (Children-Welfare Program). The LKSA (Child Welfare Agency) gives block grants to government and community and private organizations to provide housing to orphans and vulnerable children, including through foster care.

The Law on Social Welfare states that social welfare must be given to people with disabilities, including children with special needs, in order to ensure that

Box 2.3 Key Laws Governing Early Childhood Development in Indonesia

• Presidential Regulation on National Health Insurance System No. 12/2013 and its

amendment on Presidential Regulation No. 111/2013

• Child Protection Act No. 23/2002 Article 44 regarding free basic health care for poor

children, birth registration, and legal protections and services

• Government Regulation No. 33/2012 on exclusive breastfeeding

• Law No. 18/2012 on food, regarding fortification with micronutrients

• Law No. 13/2003 on manpower, regarding parental leave and nondiscrimination

• Presidential Decree No. 60/2013, regarding the HI-ECD Law No. 23/2004, regarding

elimination of domestic violence

• Law on Social Welfare No. 11/2009, regarding social protection, housing, and special

needs services.

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their basic needs are met. The definition of disability used encompasses physical, mental, and socioemotional delays and disorders, including attention deficit hyperactivity disorder and autism. The Ministry of Women Empowerment and Child Protection is the lead agency for directing special needs services, and it has established guidelines to be used by other ministries providing services to chil-dren with special needs, including the Ministry of Education, Ministry of Health, and Ministry of Information.

On the basis of the aforementioned diagnostic, a number of policy options could be considered to strengthen the legal framework for ECD:

• SocializetheissuanceofHI-ECDpolicytothelocallevel,aswellasthetech-nical guidance for its implementation. Despite having the HI-ECD policy issued, district governments still have limited information on how to imple-ment the policy.

• Considermandatingpreprimaryeducationforchildrenagesthreetosixyears.Without quality preschool, many children enter primary school without the skills they need to succeed in education. Attending quality preprimary programs is associated with many lifelong benefits to individuals, as well as to the economic well-being of a country. In the near term, the GoI could con-sider increasing attendance in preprimary education, dependent on the devel-opment of quality preschool models.

• Considermakingvaccinesformumps,rubella,andmeningitismandatoryfortheimmunization course young children receive. This would improve children’s health and reduce health care costs by decreasing the need for medical treatment.

• EncourageHIVscreeningofpregnantorvulnerablewomen,andraiseaware-ness of HIV. Universal screening of HIV in pregnant women has the potential to prevent cases of mother-to-child-transmission. Mandatory screening rec-ommendation is difficult to implement because many districts do not have laboratory facilities and human capacity to deliver HIV screening tests for pregnant women. Even when testing is available (which it may not be in all Indonesian health centers), many will opt not to be screened because of stig-ma surrounding the disease.

• Parentalleavepoliciesshouldbehighlyflexibletoallownewparentstoprovideappropriate and timely care for their newborn. Improve maternity and pater-nity leave to promote labor participation and proper caregiving for infants. Also consider socializing the importance of paternity leave since most parents have limited information on this. A baby’s need for caregiving, breastfeeding, and nurturing are greatest in the early months of life. Extending paternity leave and making the maternity period more flexible could improve babies’ health and development outcomes, as well as the well-being of mothers (which in turn has a strong impact on their children’s well-being). The current length of leave may not be adequate for parents to devote the time and energy to caregiving that is necessary for children’s healthy development. Longer parental leave makes it easier for women to remain in the workforce after having children.

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Policy Lever 1.2: Intersectoral Coordination (Rating: Established)Development in early childhood is a multidimensional process (see, for example, Naudeau et al. 2011; UNESCO-OREALC 2004; and Neuman 2007). To meet children’s diverse needs during the early years, government coordination is essen-tial, both horizontally across different sectors and vertically from the local to national levels. In many countries, nonstate actors (either domestic or interna-tional) participate in ECD service delivery; for this reason, mechanisms to coor-dinate with nonstate actors are also essential.

The HI-ECD policy is the GoI’s multisectoral ECD policy, covering educa-tion, health, nutrition, social protection, and child protection. Issued in 2013, relevant ministries and institutions are currently elaborating their work plans and budgets to implement the policy. Each fiscal year at the National Coordination Meeting, (Musrenbang), central government agencies, subnational and local government representatives, meet to coordinate their programs hosted by Ministry of National Development Planning (see figure 2.2). A national level task force is delegated to coordinate the HI-ECD policy. The policy was issued by the central government and gives numerous ministries and institutions vari-ous responsibilities to implement the policy.

The policy is endorsed by numerous bodies, including the National Population and Family Planning Agency, Cabinet Secretary, Coordinating Ministry of People’s Welfare, Ministry of National Development Planning, Ministry of Home

Figure 2.2 Intersectoral Coordination in Indonesia

Centralgovernment

ministries

Subnationalgovernment

offices

Ministry ofNational

DevelopmentPlanningChairman

Localgovernment

offices

NationalPlanningBureau

Note: Central government ministries include People’s Welfare Education and Culture, Health, Women’s Empower-ment and Child Protection, Home Affairs, Social Affairs, Religious Affairs, National Population Affairs and Family Planning Agency, and Statistic Central Bureau.

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Affairs, Ministry of Education and Culture, Ministry of Health, Ministry of Social Affairs, Ministry of Religious Affairs, and Ministry of Women Empowerment and Child Protection. The Ministry of People’s Welfare (Menko Kesra) is the lead agency coordinating ECD efforts across ministries and institutions.

The central government is responsible for the legal framework of the policy, establishing norms, standards, procedures, and criteria; and providing technical guidance supervision, advocacy and training. The subnational/provincial govern-ment provides technical assistance, supervision, advocacy, and training. The district governments’ role is to provide services, technical assistance, supervision, advocacy, training service providers, and reporting and evaluating. Coordination meetings and national and ministry-specific guidelines help ensure children receive integrated services. Service providers aim to meet regularly to coordinate service delivery. At the district level, ECD Forums and ECCE staff associations are supposed to meet at least once a month. In some districts, actors meet regu-larly; others do not. The Ministry of Education and Culture makes block grants to most districts in Indonesia for teacher meetings, known as ECE service cluster meetings. Some of the participants at these meetings provide integrated ECD services not limited to education. Participants share experiences and discuss issues of common concern.

The National Guidelines for HI-ECD services outline children’s basic needs according to their age in health, nutrition, child protection and welfare, parent-ing, early stimulation, and education. Relevant ministries jointly prepared the guidelines, with support from UNICEF. Each ministry has its own guidelines based on the tasks delegated to it by Presidential Regulation. In addition, each sector has set target goals for coverage rates for services.

On the basis of this diagnostic, a number of policy options could be considered to strengthen coordination mechanisms for ECD:

• Strengthencommunicationbetweensectorsthroughthecoordinationmeet-ing held by the HI-ECD national task force. As stated in the HI-ECD policy, the national task force should hold a coordination meeting at least once every three months.

• Establishmechanismsforcoordinationatthenationallevelbetweenstateandnonstate stakeholders. There do not seem to be meetings or structures for coordination between governmental and civil society organizations at the national level, although coordination of this nature seems to occur at the local level. Nonstate actors often provide many ECD services, and coordination with them may be necessary to provide children with a full range of services. Coordination can also help ensure all service providers follow standards for service delivery.

Policy Lever 1.3: Finance (Rating: Established)While legal frameworks and intersectoral coordination are crucial to establishing an enabling environment for ECD, adequate financial investment is needed to

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ensure that resources are available to implement policies and achieve service provision goals. Investments in ECD can yield high public returns, but are often undersupplied without government support. Investments during the early years can yield greater returns than equivalent investments made later in a child’s life cycle and can lead to long-lasting intergenerational benefits (Hanushek and Kimko 2000; Hanushek and Luque 2003; Valerio and Garcia 2012). Not only do investments in ECD generate high returns, but they can also enhance the effec-tiveness of other social investments and help governments address multiple pri-orities with single investments.

Central-level budgets use explicit criteria to determine ECD spending. In education, the GoI considers the number of children served, school construction or renovation projects, and educational materials required. Block grants to fund staff are based on the number of institutions, number of staff, and staff salaries. In the social protection and child protection sectors, the number of children covered, children’s characteristics, and geographical location are used to deter-mine allocations. In the health and nutrition sectors, ECD budget processes consider children’s characteristics, geographical location, usage, historical prece-dent, and the number of caregiver positions. The GoI could however consider adding additional criteria to its ECD funding allocation processes, such as the ability to raise revenue at the subnational level, and the number of children in subnational locations. It could also establish more precise formulas for determin-ing funding. These steps could improve fairness in allocations and efficiency by ensuring that funds are allocated where they are most needed. Establishing for-mula-based allocations also promotes transparency in budgets.

Budget coordination is expected to be strengthened under the HI-ECD pol-icy. Central and local government work plans and budgets are determined according to the National Development Planning System process. Currently, each ministry receives its budget allocation based on the Presidential Regulation and Decree which is issued each fiscal year. The relevant ministries receive allo-cation for their ECD activities, based on which they set their budgets to imple-ment the ECD tasks and goals in accordance with their respective mandates. When the HI-ECD Policy is fully implemented, ministry budgets and work plans will be more coordinated.

The government is not able to report ECD expenditure in all sectors. The GoI does report ECD spending on education, health, nutrition, and child protection, with figures provided for 2013 in table 2.4. But child and social protection spending for children is not disaggregated by age group; only an overall figure is available for all children up to the age of 18. Adding lines to child and social protection budgets to allow for identification of resources focused on young children would be helpful as the sector grows.

ECD expenditure may not be adequate to provide quality services for all. According to Law No. 20/2003 on the National Education System, a minimum of 20 percent of government spending must be on education. But funding for other sectors, as well as preschool education, may not be sufficient, and funding

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for preschools is limited. Box 2.4 summarizes the current status of government spending on ECED services. For example, in 2013, ECCE spending was 0.43 percent out of a total government expenditure on education of Rp 73,087,504,957,000. In 2012, it was 0.56 percent; in 2011, it was 0.79 percent. Evidence from Organisation for Economic Co-operation and Development countries suggest that public investment of at least 1.0 percent of gross domes-tic product (GDP) is the minimum amount necessary to ensure high-quality early childhood care and education. While higher spending does not guarantee higher quality, the level of investment has implications for access, coverage, and quality. Given the large positive externalities and potential for market failure without government support, public provision is often necessary to reach all children with the services essential to their healthy development.

Out-of-pocket expenditure refers to direct outlays by households, including gratuities and in-kind payments, to service providers. In health, this includes health practitioners and suppliers of pharmaceuticals, therapeutic appliances, and other goods and services whose primary intent is to contribute to the restoration or enhancement of the health status of individuals or population groups. Table 2.5 displays cross-country comparisons of health expenditure. Out-of-pocket health expenditure as a percentage of total health expenditure is at 45 percent according to the World Health Organization (WHO) Global Health Expenditure Database for 2012. This percentage is not too far away from the comparators in the table, but still high for a country with in principle free public health care.

Fees levied for ECD services vary. Some ECCE centers charge numerous types of fees to families, such as tuition, meals, transport, registration, and supplies. Other schools do not charge anything, or do not charge poor families. In the health sector, most services are covered for participants in the national health insurance system (JKN). Those who have not paid JKN insurance premiums, are not yet enrolled, or are not recipients of government health grants to cover premiums must pay for health services, but, as previously mentioned, out-of-pocket costs remain high.

Remuneration for ECD workers varies and may not be adequate. At govern-ment institutions, salaries for preprimary teachers entering the field should be

Table 2.4 Early Childhood Development Budget across Sectors in Indonesia, 2013

Sector Budget (IDR) Budget (USD) Percentage of GDP

Education 1,569,218,277,000 162,414,000 0.0187

Health 2,743,515,353,000 283,954,000 0.0327

Nutrition 281,488,770,000 29,134,100 0.0034

Child protection 22,206,908,000 2,298,410 0.0003

Social protection 656,087,490,000a 67,905,000 0.0078

Source: Budget documents of Education & Health Ministries (2013); the accountability reports of Social Affairs Ministry (2012); and Women Empowerment and Child Protection Ministry (2013).Note: Currency exchange rate for January 1, 2013, has been used for the conversion of the budget amounts into USD. GDP is for 2013. GDP = gross domestic product; IDR = Indonesian rupiah; USD = US dollar.a. This figure includes budget from the National Family Planning Coordinating Board (BKKBN) allocated for parenting programs.

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Box 2.4 Current Government Spending on Early Childhood Education and Development

Central government spending on ECED services is low in comparison with other subsectors

and unlike these sectors has not grown significantly. In recent years, spending by the central

government on ECED has been in the region of Rp 2–3 trillion per year compared to an over-

all central government budget for education of more than Rp 100 trillion (figure B2.4.1). Per-

haps more worrying is that the share of total central government spending on ECED has been

declining. In 2011, approximately 4 percent of central government funds were devoted to

ECED but by 2013 this share had dropped to around 2 percent.

Figure B2.4.1 Central Government Spending on Early Childhood Education and Development, 2008–13

0

1

2

3

4

0

20

40

60

80

100

120

2008 2009 2010 2011 2012 2013

IDR

trill

ion

s, n

omin

al

ECED

as

% o

f tot

al c

entr

al g

over

nm

ent

educ

atio

n s

pen

din

g

Directorate General ECED, Nonformal and Informal Education.

Other education spending

Central government ECED spending as a % of total centralgovernment spending

Note: ECED = early childhood education and development; IDR = Indonesian rupiah.

While local governments contribute substantially to the financing of ECED, the share of

total government spending devoted to the subsector remains low because of the focus on

financing compulsory basic education and teachers. The last education public expendi-

ture review found that approximately three-quarters of all public spending on ECED came

from local governments. However, ECED was still estimated to absorb only around 2 per-

cent of total government (that is central, provincial, and district governments) education

spending.

Government spending on ECED remains low in Indonesia compared with other

countries—both within the region and around the world. Indonesia spends less than

1 percent of its total education expenditure on preprimary education. In contrast, Vietnam


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competitive with salaries for primary teachers entering the field, assuming their education levels are the same. This parity in pay should provide an incentive for talented individuals to enter the ECCE field. Parent and local government contributions pay teachers at community-based preprimary schools, and the average amount varies. Private school teachers are paid a range of salaries depending on the institution. In many countries, preprimary educators are paid less than primary teachers. This discourages individuals from entering the field and contributes to high turnover of staff. Finally, salaries for community-based health workers depend on the location. Some district health offices provide honoraria, in addition to community contributions. It is difficult to gauge if salaries for community-based teachers and health workers are adequate.

On the basis of the aforementioned diagnostic, a number of policy options could be considered to strengthen financing for ECD:

• UseformulastoinformECDbudgets.Inadditiontothemultiplecriteriacur-rently considered when determining ECD budgets, consider establishing for-mulas to set spending levels. This will promote efficiency by ensuring funds go where they are most needed. This also improves transparency by providing clear guidelines on how allocations are made.

Table 2.5 Regional Comparison of Selected Health Expenditure Indicatorspercent


Out-of-pocket expenditure as a percentage of all private health expenditure 75 78 86 84 85

Out-of-pocket expenditure as a percentage of total health expenditures 45 34 58 52 49

Government expenditure on health as a percentage of GDP 3 5 4 5 7

Routine Expanded Program Immuniza-tion financed by government, 2012 — — 100 83 34

Source: WHO Global Health Expenditure Database 2012.Note: GDP = gross domestic product; — = not available.

spends 10.8 percent. Low levels of government support to ECED and the size of private

sector involvement suggest that the bulk of funding for ECED services in Indonesia come

from nongovernment sources.

Source: World Bank 2014.Note: ECED spending from the Ministry of Religious Affairs is not included. Data on spending from Directorate General ECED taken from Ditjen PAUDNI. Data for total central government spending from audited accounts (2013 is revised budget data).

Box 2.4 Current Government Spending on Early Childhood Education and Development (continued)

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• EstablishwaystotrackchildandsocialprotectionexpenditureonECD.Thecur-rent system does not disaggregate child and social protection spending on young children from sector spending on all children younger than 18 years of age. Rel-evant ministries should consider coordinating in developing their ECD budgets. The GoI could put in place a mechanism to allow for identification of ECD-specific spending.

• IncreasefundingforECCE.AtpresenttheGoIspendsasmallproportionofthe education budget on early childhood education. To ensure that all children attend high-quality preprimary schools, the GoI could consider allocating a higher percentage of its education budget to preprimary education. Recent analyses have shown that the resources required to improve access to better quality ECCE services are within reach but would require increasing ECCE investments among different stakeholders including districts, community de-velopment funds, and even by tapping private funds. Box 2.5 indicates some feasible cost projections for a proposed expansion plan for ECED and raising the quality of services provided. In addition, box 2.6 presents potential funding opportunities to improve access to ECED services through the Village Law.

Box 2.5 How Much Would It Cost to Expand Access and Raise the Quality of Early Childhood Education and Development Services for Three- to Six-Year-Olds?

As part of the World Bank’s support to Indonesia’s medium-term development plan (2015–19),

cost estimates were developed to assess the feasibility of proposed expansion plans for ECED.

A simple costing model was developed based on three sets of projections. It should be noted

that this costing model is not designed to give detailed cost estimates over the plan period

but to give a broad indication of the financial feasibility of proposed expansion plans for ECED.

Enrolment projections. The three- to six-year-old age group is used as the basis of enrol-

ment projections. The size of this age group is obtained from overall single-age population

projections provided by the UN population division and are based on the 2010 Indonesian

population census. Single-age enrolment rates in ECED are taken from Ministry of Education

and Culture data. Projections are made by changing the share of children in each age group

enrolling in ECED services. The model has been developed for a variety of scenarios for en-

rolment. The scenario presented here looks at a general expansion of ECED services to en-

sure that the government’s enrollment targets (81 percent of three- to six-year-olds) are met

by 2019. Other scenarios considered included the cost of expanding provision only for chil-

dren in the poorest 40 percent of the population, as well as to children residing in 3T dis-

tricts. These are not reported here.

Cost projections. Annual teacher costs are based on an average salary for kindergarten

teachers (Rp 36 million annually) and playgroup teachers (Rp 12 million annually) based on

national teacher registry data (NUPTK) and information from the government’s ECED project.

Overall, teacher costs for each level are projected using student–educator ratios described in

the minimum service standards. An annual cost of Rp 3 million per educator is also included


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Box 2.5 How Much Would It Cost to Expand Access and Raise the Quality of Early Childhood Education and Development Services for Three- to Six-Year-Olds? (continued)

for professional development activities. Nonteacher costs include a center-based grant (BOP)

for each preschool center and ranges from IDR 7 million per playgroup to Rp 11 million per

kindergarten. In addition to center-based grants, an amount for the operating costs of

centers, resources for purchasing toys and learning materials, as well as the building and up-

keep of one playground in each center, are included in the cost estimates. The projections

also include the costs of paying salaries of 10 ECED supervisors in each district. Center con-

struction costs are included as one-time expenditure and are based on estimated costs of

around Rp 22 million per playgroup and 45 million per kindergarten. The model assumes a

maximum center size of 40 children, and the estimates costs are based on existing block

grants provided by the Ministry of Education and Culture for these purposes.

Total education cost projections. The final component of the model combines cost and

enrolment projections to calculate the overall costs of ECED provision over the next medium-

term development plan (2015–19). It assumes that 25 percent of all enrollment occurs in play-

groups and 75 percent occurs in kindergartens.

Expanding access to ECED services such that 81 percent of all three- to six-year-olds are

enrolled by 2019 would cost on average Rp 50 trillion annually between 2015 and 2019. (See

figure B2.5.1) While this is significantly higher than current central and local government

support to ECED, it represents approximately 15 percent of government spending on educa-

tion. This would suggest that the resources required to improve access to better quality ECED

services are within reach.

Figure B2.5.1 Estimated Costs of Meeting Enrollment Targets for Three- to Six-Year-Olds with Early Childhood Education and Development Services That Satisfy the Minimum Service Standards

10

20

30

40

50

60

20192018201720162015

Teacher salary Learning materialsConstruction costsOperating costs

Teacher trainingBOPDistrict supervisors (10 per district)

PlaygroundsToys

IDR

trill

ion

Source: World Bank 2014.Note: BOP = Bantuan Operasional PAUD (government transfer program to support ECED).

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Policy Goal 2: Implementing Widely

Implementing widely refers to the scope of ECD programs available, the extent of coverage (as a share of the eligible population) and the degree of equity within ECD service provision. By definition, a focus on ECD involves (at a minimum) interventions in health, nutrition, education, and social and child protection and should target pregnant women, young children, and their parents and caregivers. A robust ECD policy should include programs in all essential sectors; provide comparable coverage and equitable access across regions and socioeconomic status—especially reaching the most disadvantaged young chil-dren and families.

Policy Lever 2.1: Scope of Programs (Rating: Established)Effective ECD systems have programs established in all essential sectors and ensure that every child and expecting mother have guaranteed access to the essential services and interventions they need to live healthfully. The scope of programs assesses the extent to which ECD programs across key sectors reach all beneficiaries. Figure 2.3 presents a summary of the key interventions needed to support young children and their families via different sectors at different stages in a child’s life.

Box 2.6 Opportunities to Improve Access to Early Childhood Education and Development Services through the Village Law

In January 2014, the Indonesian Parliament ratified the Law on Village Government

(Undang-Undang Desa—UU Desa). The UU Desa, or Law 6/2014, envisages a transfer of

national and district government resources in an amount estimated at up to US$140,000

per village per year. The law also stipulates that these funds (dana desa) should be utilized

according to the principles of transparency, accountability, and inclusion—principles

operationalized through over 15 years of implementation of the government’s community

development programs such as Kecamatan Development Program and National Program

for Community Empowerment (PNPM Mandiri). The UU Desa represents an enormous op-

portunity for villages to access resources for local development and poverty reduction

efforts. Dana desa, if invested effectively, can complement district government investments

in basic services, thereby improving access and quality of basic health, education, and infra-

structure for rural Indonesians. With strong evidence that attending ECED has great benefit

for poor children in preparing them for further education, ECED is a strong candidate for

funding by Dana Desa.

Source: World Bank 2014.

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Figure 2.3 Essential Interventions during Different Periods of Young Children’s Development

Pregnancy

Exclusivebreastfeeding

Nutrition

Health

Water andsanitation

Education

Socialprotection

Attendeddelivery

Immunizations

Deworming




Adequate sanitation

Hygiene/handwashing

Maternal education



Birthregistration


education





Birth12

months




24months

36months

54months

72months

Counseling onadequate diet during

pregnancy

Iron-folic acid forpregnant mothers

Antenatal visits


Source: Denboba et al. 2014.Note: The idea of presenting interventions by sector and/or age has been used by a number of previous authors.

ECD programs are established to target all relevant groups of beneficiaries in Indonesia. As displayed in figure 2.4, Indonesia has a range of ECD programs established in all of the relevant sectors: education, health, nutrition, and social and child protection. Interventions are established that serve pregnant women, young children, and parents and caregivers. In chapter 3, we further discuss the coverage of ECD interventions based on data from the Demographic and Health Surveys (DHS) to present the extent to which ECD programs reach out to families and young children.

The scope of nutrition programs could be expanded. Currently, the Ministry of Health is trying to tackle the prevalence of malnutrition through the Food Infants and Children National Strategy. Besides home visiting programs to pro-vide parents with health information on health and nutrition, the ministry also provides maternal depression screening and services, as well as the referrals. However, the scope of nutrition programs could be expanded to include healthy eating and exercise programs to prevent childhood obesity and feeding programs at centralized locations often available in most communities such as Posyandus (integrated village health units). ECD programs are established in all

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essential areas of focus. A variety of interventions are established in all essential areas of ECD service provision, including in health, nutrition, education, and social and child protection. Key programs are summarized in table 2.6. The table indicates that while a range of ECD interventions exist, coverage is not always universal.

On the basis of the aforementioned diagnostic, a number of policy options could be considered to strengthen the scope of programs for ECD:

• Establishmaternaldepressionscreeningandtreatmenttohelpbothmothersand children. Emerging evidence suggests that maternal depression is wide-spread in low- and middle-income countries. Maternal depression can inter-fere with bonding and impede responsive caregiving and can have negative lifelong effects on children’s cognitive and emotional development. Maternal depression is treatable, often through community-based interventions such as support groups and home visits. Interventions to prevent depression and sup-port mothers can yield high returns.

• Expandthescopeofnutritionprogramstoimprovethehealthofpregnantwomen and young children while implementing Food, Infants and Children National Strategy widely. The scope of nutrition programs could be expanded to include healthy eating and exercise programs to prevent childhood obesity, food supplements for pregnant women and young children, and feeding

Figure 2.4 Scope of Early Childhood Development Interventions in Indonesia, by Sector and Target Population

Pregnancy

TargetBenficiaries

Parents/Caregivers

Nutrition

Health

Water andsanitation

Education

Socialprotection

Immunizations


Adequate sanitation

Hygiene/Handwashing

Formal and informal ECCE centers

Services for orphans

Birthregistration

Parenting program

Children welfare program

Family hope program

12months

Breastfeeding promotion

Birth24

months

Young children

36months

54months

72months

Micronutrients for pregnant women & young children

National health insurance program (JKN)

Mother and child health program

Note: JKN = Jaminan Kesehatan Nasional.

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Table 2.6 Early Childhood Development Programs and Coverage in Indonesia

ECD intervention Coverage

State-sponsored preprimary/kindergarten education 11,256,734 children(3,963,519 in kindergarten; 212,561

in daycare; 3,154,730 in playgroup; 3,925,925 in other type of ECD)

State-sponsored early childhood care and education

Community-based early childhood care and education

Mosquito bed net distribution for children younger than 7 years of age —

Antenatal and newborn care 4,631,735 women

Childhood wellness and growth monitoring 16,266,768 children

Comprehensive immunizations 3,929,748 children

Micronutrient support for pregnant women:Ferrous supplementation 4,420,684 women

Micronutrient support for postnatal women —

Micronutrient support for young children:Vitamin A supplementation

17,675,627 children

Food supplements for young children —

Food supplements for expecting mothers —

Breastfeeding promotion programsBreastfeeding and supplementary food counseling

3,929 and 416 women

Feeding programs in preprimary/kindergarten schools —

Parenting integrated into health/community programs — (although happens to some degree at HI-ECD services)

Home visiting programs to provide parenting messages —

Programs for orphans and vulnerable children:Social welfare program for children

172,637 children (1,750 are children with special needs)

Interventions for children with special (emotional and physical) needs

Antipoverty intervention focused on ECD:Family Hope Program

32,149 pregnant women; 615,460 children younger than five years of age

Integrated services for women and child protection:Integrated services for women and children victims of violence

—

Note: ECD = early childhood development; HI-ECD = Holistic Integrated-Early Childhood Development; — = not available.

programs at preprimary schools. As discussed earlier, stunting among young children is widespread. Providing babies and children with nutritious food or the means to procure it may be one way to reduce stunting.

Policy Lever 2.2: Coverage (Rating: Emerging)A robust ECD policy should establish programs in all essential sectors, ensure high degrees of coverage and reach the entire population equitably–especially the most disadvantaged young children–so that every child and expecting mother have guaranteed access to essential ECD services. Many but not all pregnant women have access to essential ECD health interventions. The rate of births

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attended by skilled attendants is 83.1 percent, and 88 percent of pregnant women receive at least four prenatal care visits.2 Until recently, childbirth insur-ance covered the costs of delivery; deliveries are now covered for participants in the new national health care insurance system. Even without cost as a barrier, there is the possibility that pregnant women may face access issues such as lack of proximity to skilled health professionals. The percentage of pregnant women living with HIV who receive antiretroviral therapy to prevent mother-to-child transmission is not available.

Some young children lack access to basic health interventions. Several access indicators suggest that some young Indonesians do not receive preventive care and appropriate treatment for illnesses. Sixty-four percent of one-year-olds receive a complete course of immunizations against diphtheria, pertussis, and tetanus (DPT) (see table 2.7). Many less developed countries have achieved higher vaccination rates and have established systems to reach marginalized populations in remote areas. Approximately 75 percent of children younger than five years of age with suspected pneumonia are taken to a health care provider, but only 39 percent of children with suspected pneumonia receive antibiotics. Only 3 percent of children in at-risk areas sleep under an insecticide-treated net.

The level of access to nutrition interventions for young children and pregnant women could be expanded. The exclusive breastfeeding rate until the age of six months is 41.5 percent. This suggests that breastfeeding is a fairly widespread practice, but more support for mothers and education on its importance may be necessary. The anemia rate in preschool age children is 28.1 percent, according to the Basic Health Profile, 2013. According to the WHO, that level of preva-lence constitutes a moderate public health problem, therefore interventions to expand intake of iron supplement may be necessary. This could be through vitamin supplementation, or iron-fortified products. Efforts to reduce parasitic infections could also lower anemia rates. Since 2008, the law requires that iron be added to flour.

Table 2.7 Access to Essential Health Services for Young Children and Pregnant Womenpercent


One-year-old children immunized against DPT (corresponding vaccines: DPT3ß) 64 99 72 86 97

Children younger than five years of age with diarrhea receive oral rehydration/continued feeding (2009–12) 39 — 26 47 47

Children younger than five years of age with suspected pneumonia taken to health care provider (2010) 75 — 69 50 73

Pregnant women receiving antenatal care (at least four times) 88 — 37 78 60

Source: UNICEF Country Statistics 2012.Note: DPT = diphtheria, pertussis, and tetanus; UNICEF = United Nations Children’s Fund; — = not available.

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More than 36 percent of children younger than five years of age in Indonesia have moderate to severe stunting (see table 2.8). Stunting is defined as having a height (or length)-for-age more than two standard deviations below the median according to international norms. It is an indicator of chronic malnutrition. Stunting early in life can have long-term effects: it can damage health and reduce an individual’s cognitive development, educational performance, and economic productivity. This has negative consequences not only for the well-being of the individual but also for the future success of Indonesia as a country. Given this high figure, interventions to increase the amount and quality of food may be necessary. This could include offering food supplements or programs to make nutritious food more affordable for families. Increasing breastfeeding rates also has the potential to reduce stunting rates, as breastmilk has tremendous nutri-tional benefits and offers a number of protections against common child health problems. It would likely be an effective and inexpensive approach to reduce stunting rates.

The anemia rate for pregnant women is 37.1 percent, according to the Basic Health Profile, 2013. According to the WHO, that level of prevalence constitutes a moderate public health problem. Anemia can have adverse health effects: mild anemia may impair work productivity, and severe cases can increase risk of maternal and child mortality. Mandated flour fortification, an initiative to pro-vide ferrous supplementation to pregnant women, and better access to medical treatment for parasites have helped reduced the anemia rate in recent years.

Access to early childhood care and education (ECCE) in Indonesia is increas-ing. The country’s gross enrollment rate in preprimary education (five to six years) in 2011 was 46 percent. In 1991, the rate was 16 percent, and in 2002, it was 26 percent. Gross enrollment is defined as the total enrollment in a specific level of education, regardless of age, expressed as a percentage of the official school-age population corresponding to the same level of education in a given school year. It is widely used to show the general level of participation in a given level of education. The average gross enrollment rate for the Asia region for 2011

Table 2.8 Access to Essential Nutrition Services for Young Children and Pregnant Women percent


Children younger than five years of age with moderate/severe stunting (2008–12) 36 10 48 32 23

Infants exclusively breastfed until 6 months of age 42 28 46 34 17

Infants with low birth weight 9 3 28 21 5

Prevalence of anemia in pregnant women (2005) 44 29 50 44 32

Prevalence of anemia in preschool-age children 45 20 74 36 34

Source: UNICEF Country Statistics, 2012; WHO Global Database on Anemia.

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year was 62 percent. According to the UNESCO Institute for Statistics, ECCE enrollment is higher in China (69.9 percent, 2012), India (58.1 percent, 2011), the Philippines (51.5 percent, 2009), and Vietnam (77.2 percent, 2012) than in Indonesia. The Ministry of Education and Culture has set a target of 75 percent of preschool enrollment in 2015. Scale-up is intended mainly through nonformal and community-based programs.

Birth registration can be a critical first step to reach children with the services they need and protect them against exploitation. While the GoI mandates birth registration, only 67 percent of Indonesian newborns are registered at birth com-pared with 90 percent in the Philippines and 95 percent in Vietnam (77.2 per-cent, 2012) as shown in table 2.9. Building on the free birth certification service established by the government, improved efforts are needed to universalize birth registration and accelerate the issuance of birth certificates.

On the basis of this diagnostic, a number of policy options could be considered to strengthen the coverage of programs for ECD:

• Examinewhyaccesstomedicalcareforpregnantwomenisnothigherde-spite free services. According to UNICEF data, nearly one in five women in Indonesia gives birth without a skilled attendant present. Until recently, child-birth insurance covered the cost of the services and now the JKN covers it. Examine why despite free provision some women do not receive this essential medical care. It may be lack of access to skilled practitioners, lack of education on the importance of appropriate medical care, or other reasons.

• Consider covering all pregnant women in the new scheme insurance.Thetransition of maternity health insurance (Jaminan Persalinan, Jampersal) schemes into national health insurance (Jaminan Kesehatan Nasional, JKN) has resulted in lower access among pregnant women to birth insurance. Dur-ing the Jampersal era, all pregnant women regardless of their socioeconomic status were eligible for free birthing insurance. Because of cost burden, the uncovered pregnant women, especially in disadvantaged areas, tend to go back to traditional birth attendants. Universal birthing insurance will lower the rate of maternal and infant mortality.

• Expand nutrition programs to address widespread stunting and nutrientdeficits among children. More than one-third of Indonesian children younger than five years of age are stunted. This indicates that chronic malnutrition is a fact of life for many of the country’s youngest citizens. A multifaceted approach may be necessary to address this issue. Food and micronutrients

Table 2.9 Regional Comparison of Level of Access to Birth Registrationpercent


Birth registration 67 — 41 90 95

Source: UNICEF Country Statistics 2005–12.Note: — = not available.

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supplements, income supports, increased breastfeeding rates, and nutrition education may be necessary.

• ContinuetoincreaseECCEenrollment,whilealsoestablishingormaintain-ing quality. While it has increased in recent years, preschool attendance in Indonesia is still lagging. Continue efforts to expand enrollment through a variety of formal and nonformal programs.

Policy Lever 2.3: Equity (Rating: Emerging)On the basis of the robust evidence of the positive effects ECD interventions can have for children from disadvantaged backgrounds, every government should pay special attention to equitable provision of ECD services (for exam-ple, Engle et al 2011; Naudeau et al. 2011). One of the fundamental goals of any ECD policy should be to provide equitable opportunities to all young children and their families.

Boys and girls attend preprimary school at nearly the same rate. But atten-dance by poor children is far lower than the national average. In 2011, the gross enrollment rate for preprimary school was 45 percent for boys and 46 percent for girls. In the poorest quintile, there are 8,077,590 children age five years and younger. Of those, 1,029,489 are enrolled in an ECCE center of any kind. The ECCE enrollment rate for the poorest fifth of the population is approximately 12.7 percent. This is far below the national enrollment average of 46 percent. School fees, lack of accessible schools in poorer areas, low quality, and lack of knowledge about the importance of preschool may be barriers to attendance for children from poor families. Of the children from poor families who do attend preschool, it is difficult to gauge if the quality of the schools they attend is equal to the quality of schools attended by wealthier children.

Children with special needs may not have full access to preschool. Under the national education law every child is entitled to a quality education for nine years, and the government must provide inclusive education and special services for children with special needs. Preprimary attendance is not required or free in Indonesia, and guarantees of access do not exist for preschool aged children with special needs. Government data state that there are 112,000 children with spe-cial needs in Indonesia, but it is not known how many attend preprimary school (Ministry of Women Empowerment and Child Protection and Central Bureau of Statistics 2012). The HI-ECD policy has the goal of providing quality ECD services, including education, to all children, including children with special needs. Currently, there are few mechanisms in place to implement this policy goal. Accessible facilities, staff training, and identification of children with spe-cial needs will all be necessary to provide all children with appropriate services.

Access to ECD services varies by economic status and geographical loca-tion. The birth registration ratio between the richest 20 percent of the Indonesian population and the poorest 20 percent is 2.2 (see figure 2.5). While 97 percent of women from the highest income quintile have a skilled attendant at delivery, only 58 percent of women from the poorest quintile do.

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Figure 2.5 Disparities between Bottom and Top Quintiles of Wealth

Birth registration

Underweight prevalencein children younger than

five years old

Skilled attendant at birth

0 302010 605040 70 80 90 100

Percentage

41

88

22.7

10.4

58

97

Poorest 20% Richest 20%

Source: UNICEF Multiple Indicator Cluster Survey 2008–12.

While having appropriate medical personnel at childbirth is nearly universal for wealthy women, just less than half of poor women have no one skilled to care for them and their babies at childbirth. Children younger than five years of age who are underweight are 2.2 times more common among families in the poorest quintile than among the wealthiest quintile.

Figure 2.6 Disparities between Urban and Rural Areas

0 302010 605040 70 80

58

76

74.6

97

73.4

43.5

90 100Percentage

Birth registration

Skilled attendantat birth

Improvedsanitation

facilities

Rural Urban

Source: UNICEF Multiple Indicator Cluster Survey 2008–12.

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Disparities in access to ECD services exist between urban and rural areas, although they are not as vast as those by household wealth. Birth registration is higher in urban areas than in rural areas (see figure 2.6). Skilled personnel attend deliveries in urban areas at the rate of 91.8 percent and 74.6 percent in rural areas. The underweight prevalence in children younger than five years of age is 15.2 percent among children in urban areas versus 20.7 percent among children in rural areas. In urban areas, 73.4 percent of residents use improved sanitation facilities; the rate is 43.5 percent in rural areas.

On the basis of the aforementioned diagnostic, a number of policy options could be considered to strengthen equity in programs for ECD:

• Address the large inequities in access to ECD services between rich and poor families and families in urban and remote areas. Children from poor families face numerous disadvantages starting even before birth. These inequalities early in life widen over time if effective interventions are not implemented. Addressing inequality early in life is effective and cost efficient. Investments in ECD are crucial to ensure that all children have the opportunity to develop their full potential. Increasing coverage rates for services may address some of these disparities. Improving quality of services may also reduce inequities, as the quality of services received by poor families may be lower than those re-ceived by wealthier families.

• Examine whether mechanisms exist to provide quality ECD services for chil-dren with special needs. While children with special needs are guaranteed access to education and other ECD services under the law, it is not clear that appropriate programs exist to serve all children who need them. Training per-sonnel, upgrading facilities, and establishing ways to identify children in need of special services may be necessary.

Policy Goal 3: Monitoring and Assuring Quality

Monitoring and assuring quality refers to the existence of information systems to monitor access to ECD services and outcomes across children, standards for ECD services and systems to monitor and enforce compliance with those standards. Ensuring the quality of ECD interventions is vital because evidence has shown that unless programs are of high quality, the impact on children can be negligible, or even detrimental.

Policy Lever 3.1: Data Availability (Rating: Established)Accurate, comprehensive, and timely data collection can promote more effec-tive policy making. Well-developed information systems can improve decision making. In particular, data can inform policy choices regarding the volume and allocation of public financing, staff recruitment and training, program quality, adherence to standards, and efforts to target children most in need.

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The GoI collects a wide range of administrative data on access to ECD. Administrative data reflect total uptake of services and are gathered through either a census or records made upon receipt of service. Across all sectors, the government collects data on enrollment and training of service providers. Health centers issue monthly reports, with information on usage of health services and nutrition interventions by children by children’s age. Health centers do not collect data on usage by socioeconomic status, ethnic background, or children’s residence in an urban or rural location. The Ministry of Social Affairs and Ministry of Woman Empowerment and Child Protection have data on the num-ber of cases in the children protection system. However, the data are differently collected between ministries and sometimes outdated.

In the ECCE sector, limited data are collected to track background character-istics and child outcomes. Data on education enrollment by urban/rural location, province, gender, and socioeconomic background are tracked. The GoI does not collect education enrollment data by ethnic background, mother tongue, or spe-cial needs status. The GoI has data on the number of ECD-aged children with special needs, but does not collect information on how many of those children are enrolled in ECCE centers.

The GoI collects many types of survey data on ECD access and outcomes. Indonesia participates in UNICEF’s Multiple Indicator Cluster Survey (MICS). The survey yields estimates on a number of indicators of children’s well-being in a country, including those related to education, health, and child protection. The survey findings allow for comparison of access and outcomes by household wealth and urban/rural location. Recently, the MICS added a new subset of indicators on early childhood development. These data will provide a measure of children’s developmental status across multiple domains. Indonesia could col-lect survey data on these indicators to provide a more nuanced picture of the country’s young children.

Individual children’s development outcomes are not tracked. The GoI does not track children’s individual development outcomes in any systematic way. It does not track children’s outcomes in preprimary education. While strong in other types of data collection, Indonesia could benefit from establishing a system to collect and analyze information on individual children’s developmental out-comes across several domains: physical, cognitive, socioemotional, and linguistic. Development should be assessed as comprehensively as possible whenever fea-sible because a child’s development in one domain often acts as a catalyst for development in another. The information can be used to establish a baseline and document the magnitude of a problem, identify children requiring referrals for additional services, assess the specific types of ECD interventions that are most and cost effective in a given context or for specific populations, and inform pol-icy dialogue for future planning.

On the basis of the aforementioned diagnostic, a number of policy options could be considered to strengthen data availability for ECD:

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• Monitor individual child development outcomes. Given the holistic nature of children’s development, it is important to monitor their development as comprehensively as possible. Gathering and monitoring information in one accessible file can help identify children in need interventions. A comprehen-sive monitoring system will also help evaluate progress under the HI-ECD policy and identify issues that need more efforts.

• Monitoring individual outcomes at health sector is at advanced level through early detection program (Stimulasi dan Intervensi Dini Tumbuh Kembang, SDIDTK) held by the Ministry of Health. However, the implementation should be routinely done across Indonesia by providing the qualified health workers.

• Participate in gathering MICS ECD subindicators. MICS data yield a rich snapshot of the state of a country’s children. The new subset of MICS ECD subindicators should provide information useful to policy makers.

Policy Lever 3.2: Quality Standards (Rating: Established)Ensuring quality ECD service provision is essential. A focus on access—without a commensurate focus on ensuring quality—jeopardizes the very benefits that

Table 2.10 Availability of Data to Monitor Early Childhood Development in Indonesia

Administrative data

Indicator Tracked

ECCE enrollment rates by region ✓Number of special needs children enrolled in ECCE ×

Number of children attending well-child visits ✓

Number of children benefitting from public nutrition interventions ✓

Number of women receiving prenatal nutrition interventions ✓

Number of children enrolled in ECCE by subnational region ✓

Average per student-to-teacher ratio in public ECCE ✓

Is ECCE spending in education sector differentiated within education budget? ✓

Is ECD spending in health sector differentiated within health budget? ✓

Survey data

Indicator (%) Tracked

Population consuming iodized salt ✓

Vitamin A supplementation rate for children 6–59 months ✓

Anemia prevalence amongst pregnant women ✓

Children younger than five years of age registered at birth ✓

Children immunized against DPT3 at age 12 months ✓

Pregnant women who attend four antenatal visits ✓

Children enrolled in ECCE by socioeconomic status ×

Note: ECD = early childhood development; ECCE = early childhood care and education; DPT = diphtheria, pertussis, and tetanus.

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policy makers hope children will gain through ECD interventions. The quality of ECD programs is directly related to better cognitive and social development in children (for example, Bryce et al. 2003; Naudeau et al. 2011; Victoria et al. 2008).

Learning standards are established for ECCE. A new curriculum is under development. The Regulation of the Education and Culture Minister No. 58/2009 lays out what young children should learn and know according to their age. The standards, which were established by the Board of National Standards of Education, cover cognitive development, language skills, socioemotional development, physical development, motor skills, arts, religion, and morality.

The Ministry of Education and Culture is developing a new curriculum, which it will endorse when it is ready for implementation. The Regulation of the Education and Culture Minister No. 58/2009, the Generic Menu for ECE Learning, and the Guidelines for Providing ECED Services inform the current curriculum. The kindergarten and Grade 1 curricula are coherent and continu-ous, with roughly similar core competencies and themes.

Professional qualification requirements for ECCE educators and caregivers exist. The Regulation of Education and Culture Minister No. 16/2007 on Teachers’ Academic Qualification and Competencies requires that teachers in formal ECCE centers hold at minimum a postsecondary degree in ECD or psy-chology. The degree can be either a D-4 (four-year diploma) or an S-1 (bachelor’s degree). The Regulation of the Education and Culture Minister No. 58/2009 on Early Child Education Standards requires that teacher assistants, who work pri-marily in nonformal ECCE centers, must have some postsecondary training specialized in ECD. This can be either at D-2 (two-year diploma) from an accredited training institution, or graduation from secondary school plus an ECD certificate from an accredited training institution. The same regulation requires that caregivers (mostly in nonformal centers) have graduated from secondary school or another similar level of education.

Educators have some opportunities for professional development. Block grants fund ECD teacher associations and private education institutions to con-duct teacher training programs. One type of course offers an upgrade to educa-tors’ academic qualification. The Directorate of Teachers and Education Personnel manages a basic-level 48-hour course, an intermediate-level 64-hour course, and an advanced 80-hour course. These courses cover health, nutrition, cognitive development, social and emotional development, inclusive education, parenting, curriculum, and learning plans. In-service training is not mandatory. However, because of capacity constraints, these training programs are not avail-able to all educators who may want to participate. Candidates for teaching degrees must complete a preservice practicum.

Infrastructure and service delivery standards are established for ECCE centers. The Minister of Education and Culture Regulation No. 58/2009 on Early Child Education Standards sets child-to-teacher ratio requirements for ECCE centers.

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The child-to-teacher ratio standards are as follows: 15:1 for five-year-old children; 12:1 for four-year-old children; 10:1 for three-year-old children; 8:1 for two-year-old children; 6:1 for one-year-old children; and 4:1 for children younger than 12 months. These figures are roughly in line with those in many Organisation for Economic Co-operation and Development countries.

ECCE centers must be open for a minimum number of hours according to Indonesian standards. For children younger than 24 months old, centers should provide 120 minutes of education per week. Children between 24 and 48 months should be able to attend 180 minutes per day, two days a week. Children between 48 and 72 months attending formal ECCE centers should have 150 to 180 min-utes per day of school for five or six days per week. At informal centers, children of the same age should be able to attend 180 minutes per day, three days a week.

Under the Regulation of Education and Culture Minister No. 58/2009 on Early Childhood Education Standards, ECCE centers must have at least 3 meters square of interior space per child. Centers must also have hygienic toilet facilities. Daycare centers must have areas for sleeping, eating, and bathing. Educational toys should be available, as well as appropriate indoor and outdoor play spaces. To obtain an ECCE operational permit, centers must provide toilets, a water supply, sanitation systems, and washbasins.

The Ministry of Public Works, Directorate General of Building issues con-struction standards and permits applicable to all buildings in the country. There are no construction standards specific to ECCE centers. The standards cover necessary aspects of safe and appropriate facilities, except for access to potable water. Permits for new construction require submission of detailed construc-tion plans. Health facilities must also comply with construction standards.

There are established registration and accreditation procedures for ECCE facilities. Both formal and nonformal ECCE centers are required to be accredit-ed. The Minister of Education and Culture Regulation No. 52/2009 on kinder-garten accreditation establishes procedures forkindergartens, and the National Accreditation Board for Non-formal Education has an accreditation instrument for nonformal centers. Accreditation renewal occurs every three years, at which point announced inspections are conducted.

On the basis of the aforementioned diagnostic, a number of policy options could be considered to strengthen quality standards for ECD:

• Expand in-service training and professional development opportunities for ECCE educators. Currently, in-service training programs are not widely avail-able, nor is any kind of professional development mandatory. Consider man-dating participation in accessible, relevant training.

• Increase the minimum hours at ECCE hours to improve quality. Program intensity matters for quality. International best practice suggests a program of at least 15 hours per week for three-year-olds. While ECCE enrollment is expanding, if the program intensity is too low, the impact may be limited.

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• Establish ECED training for health workers (for example, Posyandu cadres and village midwives) by combining health, parenting, and early stimulation materials. This has contributed to the quality of integrated ECD services.

Policy Lever 3.3: Compliance with Standards (Rating: Latent)Establishing standards is essential to providing quality ECD services and to promoting the healthy development of children. Once standards have been established, it is critical that mechanisms are put in place to ensure compliance with standards.

Some ECCE teachers comply with qualifications standards and training requirements. There are 433,081 ECCE educators according to government data (Buku Data PAUDNI 2012). Almost 15 percent have a bachelor’s degree or higher. Approximately 25 percent have postsecondary schooling, but not a full four-year degree, and for approximately 39 percent of educators, the highest level of educational attainment is upper secondary school. About 3 percent have com-pleted only lower secondary school. Qualification requirements differ according to the age of children in a classroom, and those figures do not indicate with which age group these educators work, so it is somewhat difficult to gauge com-pliance with qualifications standards. Nevertheless, these figures do indicate that compliance is far from universal. Roughly 5 percent of these educators partici-pated in in-service training in recent years.

Some ECCE facilities comply with service delivery and infrastructure stan-dards. The average child-to-teacher ratio across ECCE centers in Indonesia is 8:1. Ratios for different age groups are not available, so it is difficult to assess fully if ratios comply with standards. However, it is likely that most centers comply, and some may even have lower ratios. The average number of hours ECCE facilities are open per week is between one and three hours. Again, because that average does not differentiate between age groups served, it is difficult to gauge compli-ance with the standard, but it seems likely that many centers do not adhere to the minimum opening hours.

The ECE Directorate and district Public Works Offices do not collect data on how many ECCE facilities have construction permits and comply with infra-structure standards. It is likely that formal education centers comply with infra-structure requirements, but the level of compliance in nonformal centers is less clear. Data are not disaggregated by state and nonstate facilities.

Most ECCE facilities are not accredited. In 2012, there were 10,077 accred-ited ECCE centers in Indonesia, and 152,671 nonaccredited centers. This means that only 6 percent of facilities are accredited. Quality may be lower at nonaccredited schools. More urgently, children’s safety may be at risk. Unsafe facilities and lack of staff to supervise and care for children can endanger children.

On the basis of the aforementioned diagnostic, a number of policy options could be considered to strengthen compliance with standards for ECD:

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• Ensure that ECCE educators are qualified, particularly at nonformal centers. Consider why many ECCE staff do not meet the qualifications requirements. It may be that educational opportunities are too expensive or not accessible to them, or there may be few incentives to qualification for both individuals and the centers that employ them.

• Examine why ECCE center accreditation rates are so low. The failure of most childcare centers to meet standards for accreditation is cause for concern about both program quality and children’s safety. The GoI could examine the reasons behind this. It may be that there are no enforcement mechanisms for failure to comply, costs and procedures to apply and comply are prohibitive, and/or there are inadequate inspectors and personnel to guide centers to meet requirements.

• Revitalize the role of the supervisor in quality assurance. ECED supervisor (Penilik) is the one who, by Minister of State Apparatus and Bureaucracy Reform No. 14/2010, is responsible for delivering quality assurance for ECED services. This can be done through capacity building for the supervisor, the development of tools, such as monitoring and evaluation tool to support them in the delivery of their role in quality assurance, and better institutional and organizational supports for supervisor.

• Establish an accreditation system with rating. It is urgently important for the achievement of quality ECED services. With the provision of rating, stage of quality services could be determined.

Benchmarking

Overall, table 2.11 presents the classification of ECD policy in Indonesia within each of the nine policy levers and three policy goals. The SABER-ECD classification system does not rank countries according to any overall scoring; rather, it is intended to share information on how different ECD systems address the same policy challenges. Table 2.12 presents the status of ECD

Table 2.11 Benchmarking Early Childhood Development Policy in Indonesia

Policy goal Level of development Policy lever Level of development


Legal framework

Intersectoral coordination

Finance

Implementing widely

Scope of programs

Coverage

Equity


Data availability

Quality standards

Compliance with standards


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policy development in Indonesia alongside a selection of other countries (a more detailed comparison is provided in chapter 3). Sweden is home to one of the world’s most comprehensive and developed ECD policies and achieves a benchmarking of “Advanced” in all nine policy levers. Indonesia is on average on par (slightly higher or lower in terms of average rating) with countries such as Chile and Turkey. On the Compliance with Standards policy lever, it ranks lower than these four countries.

It is important however to note that the existence of laws and policies alone do not always guarantee a correlation with desired ECD outcomes. In many countries, policies on paper and the reality of access and service delivery on the ground are not aligned.

Table 2.13 compares ECD policies in Indonesia with ECD outcomes. The GoI has mandated many key policies, but policy implementation has not always been highly successful. Despite requirements for childhood immunizations and birth registration, roughly one-third of child are not fully immunized or registered at

Table 2.12 Comparison of Indonesia Ratings with Selected Other Countries


Policy goal Policy lever Indonesia Australia Chile Sweden Turkey


Legal framework

Coordination

Finance

Implementing widely

Scope of programs

Coverage

Equity


Data availability

Quality standards



Table 2.13 Comparing Early Childhood Development Policies with Outcomes in Indonesia

Policy Outcomes

Law complies with the International Code of Marketing of Breast Milk Substitutes

Exclusive breastfeeding rate (>6 months): 41.5%

Indonesia has national policy to encourage the iodization of salt Household iodized salt consumption 62.3%

Preprimary school is not compulsory and often not free Preprimary school enrollment: 46%

Young children are required to receive a complete course of childhood immunizations

Children with DPT (12–23 months): 64%

Policy mandates the registration of children at birth in Indonesia Completeness of birth registration: 67%

Note: DPT = diphtheria, pertussis, and tetanus.

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birth. Notably, even without mandatory preprimary attendance and fees at many programs, almost half of children attend some kind of ECCE program. This is encouraging, and suggests that with expanded access children will continue to attend preschool at higher rates.

Conclusion

The SABER-ECD initiative was designed to enable ECD policy makers and development partners to identify opportunities for further development of effective ECD systems. This chapter has presented a framework to compare Indonesia’s ECD system with other countries in the region and internation-ally. Each of the nine policy levers was examined in detail, and some policy options were identified to strengthen ECD. The main conclusions are as follows:

• Establishing an enabling environment: Indonesia has enacted many key laws to ensure young children’s well-being. The HI-ECD policy is an important step to expand access to and quality of essential ECD services. Funding for the sector may be inadequate.

• Implementing widely: The scope of ECD programs in Indonesia is generally broad, but could be expanded, particularly in nutrition. Coverage rates to some services need improvement. Childhood malnutrition rates are high in the country. Vast disparities in services and outcomes exist between wealthier and poorer families, as well as between families living in urban and rural loca-tions. Children with special needs may not have access to appropriate services, despite policy goals to provide inclusive service.

• Monitoring and assuring quality: Indonesia collects a wide variety of adminis-trative and survey data. The government has established many important ECD delivery and infrastructure standards. Some teachers do not comply with qualifications requirements, and only a small percentage of ECCE cen-ters are accredited.

Table 2.14 summarizes the key policy options identified to inform policy dialogue and improve the provision of essential ECD services in Indonesia. The HI-ECD policy shows a commitment to improving services for young children in the country. The challenge to address disparities between rich and poor, low access to services, and quality issues will be largely in implementation. The poli-cy options are classified into short- and medium-term options according to potentially required implementation timeframe.

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Table 2.14 Summary of Policy Options to Improve Early Childhood Development Policy Development in Indonesia

Short term (within 2 years) Medium term (3–5 years)


Use formulas (such as capitation, but possibly with targeting to the most vulnerable as well) to inform ECD budgets to improve efficiency and transparency.

Socialize the issuance of HI-ECD policy to local level, along with technical guidance for its implementation.

Establish mechanisms for coordination at the national level between state and nonstate stakeholders, as well as cost-sharing for multisectoral agencies that are part of the HI-ECD program.

Mandate attendance in quality preprimary education for children ages 3–6 years.

Strengthen communication across sectors through the co-ordination meetings held by HI-ECD national task force.

Extend maternity and paternity leave to allow parents greater flexibility for labor-force participation and proper caregiving for infants, also make maternity period more flexible.

Establish ways to track child and social protection expen-ditures for ECD-aged children.

Increase funding for early childhood care and education to ensure quality and access.

Make mandatory the immunization course for mumps, rubella, and meningitis.


Examine whether mechanisms exist to provide quality ECD services for children with special needs.

Establish maternal depression screening and treatment to help both mothers and children.

Give communities incentives to experiment with ap-proaches to providing integrated ECD services using existing infrastructure.

Expand nutrition programs to address stunting and nutri-ent deficits among children

Consider covering all pregnant women in the new insur-ance scheme (Jaminan Kesehatan Nasional, JKN).

Continue to increase preprimary enrollment, while also addressing quality issues.

Address the large inequities in access to ECD services between rich and poor families, and families in urban and remote areas.


Examine why ECED center accreditation rates are so low. Monitor individual child development outcomes.

Establish an accreditation system with quality ratings. Establish an advanced system to monitor individual health outcomes through early detection program (Stimulasi dan Intervensi Dini Tumbuh Kembang, SDIDTK).

Revitalize the role of ECD supervisors in quality assurance. Expand in-service training and professional development opportunities for early childhood educators

Broaden training for health workers (for example, Posyan-du cadre and village midwives) by combining attention to health, parenting, and early stimulation.

Ensure that early childhood educators are qualified, par-ticularly in nonformal centers.

Increase the minimum hours of attendance at centers to increase dosage and improve quality.

Note: ECD = early childhood development; HI-ECD = Holistic Integrated-Early Childhood Development.

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Notes

1. Indonesian National AIDS Commission, 2012. Republic of Indonesia Country Report on the Follow up to the Declaration of Commitment on HIV/AIDS (UNGASS). Reporting Period 2010. http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_ID_Narrative_Report.pdf.

2. These figures are from UNICEF’s Multiple Indicator Cluster Survey 2008–2012 (used throughout this report for cross-country comparability reason). Yet, the Indonesia Health Profile 2012 states that 88.6 percent of births are delivered in the presence of skilled attendants and 90.1 percent of pregnant women receive at least four prenatal care visits.

http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_ID_Narrative_Report.pdf

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http://www.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_ID_Narrative_Report.pdf


Abstract

In the Systems Approach for Better Education Results-Early Childhood Development (SABER-ECD) framework, the second policy goal refers to the extent to which policies and programs are implemented widely. Questions are asked as to the scope of the programs being implemented, their coverage, and the equity in coverage between groups or regions. This chapter digs deeper into the question of whether essential ECD interventions are implemented in the country, with a focus on differences between provinces in coverage rates. On the basis of a framework identifying 25 essential interventions for young children, the chapter provides data on national and provincial level coverage. The 25 inter-ventions are grouped into five packages defined in terms of when the interven-tions should be implemented: the pregnancy, birth, child health, preschool, and family support packages. Overall, information is available in the household sur-veys for 19 of the 25 interventions considered, so the diagnostic provided is fairly comprehensive.

Introduction

The objective of this chapter, which provides summary results from a more detailed study (Heejin Kim and Wodon 2015), is to document the extent to which children and families benefit from essential early childhood development (ECD) interventions in Indonesia, focusing on differences in coverage between provinces. The framework follows Denboba et al. (2014), who identify 25 essen-tial ECD interventions, most of which can be tracked using secondary data origi-nated from household surveys, and especially Demographic and Health Surveys. This framework is not unique, and other efforts have been made to think through investments in ECD (see, for example, Britto et al. 2013, as well as Naudeau et al. (2011), about entry points for effective ECD programs). But the framework suggested by Denboba et al. has the benefit of being simple and useful for orga-nizing descriptive empirical work on the coverage of various interventions.

C H A P T E R 3

Coverage of Interventions at the Provincial LevelJanice Heejin Kim and Quentin Wodon

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44 Coverage of Interventions at the Provincial Level


The chapter is structured as follows: chapter 2 introduces the 25 ECD interventions and documents the sources of data used for the coverage analysis. This chapter presents the data on the coverage of essential interventions. Chapter 4 discusses the relationship between coverage levels and the level of economic development of the provinces. A brief conclusion follows.

Framework and Data

The 25 essential interventions proposed by Denboba et al. (2014) is pro-vided in figure 3.1, both according to the sectors to which the interventions belong and the time period in the life of children to which they apply. In terms of time periods, the interventions can be grouped into five packages: the pregnancy, birth, child health, preschool, and family support packages. As noted in box 3.1, these interventions have been shown to have high returns.

The assessment of the coverage of the 25 interventions is based for most inter-ventions on publicly available data from the 2002, 2007, and 2012 Demographic and Health Surveys. In the case of interventions for the preschool package, the information is based on data from the 2007 and 2012 SUSENAS surveys. All these surveys are representative at the provincial level, hence this is the level at

Figure 3.1 Essential Interventions for Young Children

a. By sector

Pregnancy

Counseling onadequate diet during

pregnancyExclusive

breastfeedingNutrition

Health

Water andsanitation

Education

Socialprotection

Iron-folic acid forpregnant mothers

Antenatal visits

Attendeddelivery

Immunizations

Deworming


Adequate sanitation

Hygiene/handwashing

Maternal education



Birthregistration


education




Birth12

Months





24Months

36Months

54Months

72Months





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Coverage of Interventions at the Provincial Level 45


Figure 3.1 Essential Interventions for Young Children (continued)

b. By age

Pregnancy Birth 12Months

24Months

36Months

48Months

60Months

Preschool educationearly childhood andpreprimary programs;Continuity to qualityprimary schools

5.Preschoolpackage

Immunizations; deworming; prevention and treatment of acutemalnutrition; complementary feeding and adequate, nutritious, and safediet; therapeutic zinc supplementation for diarrhea

3.Birth

package

Attendeddelivery;exclusive

breastfeedingbirth

registration

2.Pregnancy

package

Antenatal care;iron & folic

acid;counseling onadequate diets

1.Family

supportpackage

Parental support for vulnerable families: Planning for family size and spacing; maternaleducation; parenting and social networks of support/community education; parental leaveand adequate childcare; prevention and treatment of maternal depression; social assistancetransfer programs; child protection regulatory frameworks

Health, nutrition, and sanitation for families: Access to healthcare; access to safe water;adequate sanitation; hygiene/handwashing; micronutrient supplementation and fortification

4.Child health

&development

package


which data are provided and analyzed. As shown in table 3.1, information in the surveys is available for 19 of the 25 interventions, including many of the most important ones. Overall, the diagnostic of the coverage of ECD interventions is thus comprehensive. An annex table provides a more complete list and definitions of indicators used for measuring coverage—and in a few cases outcomes.

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Table 3.1 Data Availability on Essential Interventions

Intervention Availability in DHS

Family support package

1. Maternal education IDHS 2002/03, 2007, 2012

2. Planning for family size and spacing IDHS 2002/03, 2007, 2012

3. Education about early stimulation and growth —

4. Social assistance transfer programs —

Box 3.1 Essential Early Childhood Development Interventions Have High Returns

In this study, the ECD period refers to a child’s growth and development starting at concep-

tion and until entry in primary school. Research suggests that interventions in the five ECD

packages suggested by Denboba et al. (2014) have high returns. Examples of such high re-

turns are as follows:

Family support package: In Africa and Asia, access to safe water can have a 3.4:1 benefit-to-

cost ratio and adequate sanitation can have a 4–7:1 benefit-to-cost ratio (Rijsberman and

Zwane 2012). In Africa, South America, Europe, and Southeast Asia regions, food fortification

with iron and other micronutrients can have a benefit-to-cost ratio as high as 37:1 (Horton

1992). Estimates from Africa, East Asia and the Pacific, and South Asia regions indicate that

salt iodization can have a benefit-to-cost ratio as high as 30:1 (Horton, Alderman, and Rivera

2008). In these same regions, vitamin A can cost US$3–16 per disability-adjusted life year

saved (Ching et al. 2000; Fiedler 2000; Horton and Ross 2003).

Pregnancy package: Iron supplementation for pregnant mothers costs from $66 (African

subregion with very high adult and high child mortality) – $115 (Southeast Asian subregion

with high rates of adult and child mortality) per disability-adjusted life year saved (Baltussen,

Knai, and Sharan 2004).

Birth package: In South Asia and Sub-Saharan Africa, a package of maternal and neonatal

health packages costs $3,337–$6,129 per death averted and $92–$148 per disability-adjusted

life year averted (Laxminarayan, Chow, and Shahid-Salles 2006). Breastfeeding promotion pro-

grams, which can prevent diarrhea, cost $527–$2,000 per disability-adjusted life year (ibid).

Child health and development package: Immunizations can have a benefit-to-cost ratio up

to 20:1 (Barninghausen et al. 2009). In Tanzania, Zinc supplementation for diarrhea manage-

ment may cost $73 per DALYs saved (Robberstad et al. 2004). Estimates from Africa, East Asia

and the Pacific, and South Asia regions indicate that optimal feeding may cost $500–$1,000

per disability-adjusted life year saved (Horton et al. 2010) and deworming can have a benefit-

to-cost ratio as high as 6:1 (Horton, Alderman, and Rivera 2008).

Preschool package: Increasing preschool enrollment to 50 percent of all children in low-

and middle-come countries could result in lifetime earnings gains from $14–$34 billon (Engle

et al. 2011). High-quality ECD programs targeting vulnerable groups in the United States have

an annual rate of return of 7–16 percent (Heckman et al. 2009; Rolnick and Grunewald 2007).



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Coverage of Essential Interventions

Family Support PackageFamilies play a critical role in addressing children’s development needs. While some ECD interventions are age specific, others are required throughout the ECD period. Denboba et al. (2014) identify 12 interventions/services in their children and families support package which are required throughout the ECD period. The interventions are (1) maternal education; (2) planning for family size and spacing; (3) education about early stimulation, growth, and develop-ment; (4) social assistance transfer programs; (5) prevention and treatment of parental depression; (6) parental leave and adequate childcare; (7) child protec-tion services; (8) access health care; (9) micronutrients supplementation and fortification; (10) access to safe water; (11) access to sanitation; and finally (12) hygiene and hand washing. As reviewed in Denboba et al. (2014), these inter-ventions often have high benefits. Examples of such benefits are as follows:

5. Prevention and treatment of parental depression —

6. Parental leave and child care —

7. Child protection services —

8. Access to healthcare IDHS 2002/03, 2007, 2012

9. Micronutrient supplementation and fortification IDHS 2002/03, 2007, 2012

10. Access to safe water IDHS 2002/03, 2007, 2012

11. Adequate sanitation IDHS 2002/03, 2007, 2012

12. Hygiene and hand washing IDHS 2002/03, 2007, 2012

Pregnancy package

13. Antenatal care IDHS 2002/03, 2007, 2012

14. Iron and folic acid for pregnant mothers IDHS 2002/03, 2007, 2012

15. Counseling on adequate diet for pregnant mothers IDHS 2002/03, 2007, 2012

Birth package

16. Skilled attendance at delivery IDHS 2002/03, 2007, 2012

17. Birth registration IDHS 2002/03, 2007, 2012

18. Exclusive breastfeeding IDHS 2002/03, 2007, 2012

Child health and development package

19. Immunizations IDHS 2002/03, 2007, 2012

20. Adequate, nutritious, and safe diet IDHS 2002/03, 2007, 2012

21. Therapeutic zinc supplementation for diarrhea IDHS 2002/03, 2007, 2012

22. Prevention and treatment of acute malnutrition —

23. Deworming IDHS 2002/03, 2007, 2012

Preschool package

24. Preprimary education SUSENAS 2007, 2010

25. Continuity to primary SUSENAS and BPS Indonesia 2007, 2010

Note: BPS = Biro Pusat Statistik (Central Bureau of Statistics); IDHS = Indonesia Demographic and Health Survey; — = not available.

Table 3.1 Data Availability on Essential Interventions (continued)

Intervention Availability in DHS

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• Ahigherlevelofeducationamongmothersbenefitstheirchildreninmultipleways, not only for a range of health and nutrition outcomes but also for en-rollment in early child care and education programs (for example, Greenberg 2011; Lombardi et al. 2014).

• Planning for family size and spacing including through contraceptive usehelps parents anticipate and attain their desired number of children. Spacing improves pregnancies and deliveries and helps reduce maternal mortality (Seyfried 2011; WHO 2014).

• SupportandeducationforparentsthroughhomevisitingprogramsandECDcampaigns helps them learn about child health, growth, and development. This may improve feeding practices (Aboud and Akhter 2011; Bentley et al. 2010), early stimulation (Landry, Smith, and Swank, 2006; Young, 2002), and cognitive and language development (Engle et al. 2011). Child–parent inter-actions also enhance physical, cognitive, and socioemotional development (Grantham-McGregor et al. 2007), thereby improving future earnings (Heck-man and Masterov 2007).

• Targetedtransferprogramshelpparentsprovidefortheirchildren,increasingfood consumption and dietary diversity (Ruel and Alderman 2013). The pro-grams help reach vulnerable children and may improve school attendance, birth registration rates, and access to health care, while reducing child labor and violence (Barrientos et al. 2013).

• Preventionandtreatmentofmaternaldepressionfrompregnancytotheearlyyears of motherhood helps reduce risks for children. Community-based inter-ventions have been shown to reduce depressive symptoms, improve maternal sensitivity and infant attachment, infant health, and time spent playing with infants (Walker et al. 2011).

• Parental leaveandchildcareresourceshelpparentscater to theirchildren(International Labour Organization 2010). They may reduce neonatal mor-tality, infant mortality and under-five mortality (Heymann, Raub, and Earle 2011). The programs may pay for themselves (Immervoll and Barber 2005) by increasing women’s labor force participation, thereby lowing gender in-equality (International Labour Organization 2010).

• Childprotectionservicesaswellaspositivefamilyroutinesreducerisksofdomestic violence affecting children’s socioemotional development (Alder-man 2011). Improving institutional environment of nonparental group resi-dential care can also lead to benefits in child cognitive and social-emotional competence (Walker et al. 2011).

• Accesstoandaffordabilityofhealthcarearekeyforhouseholdstousetheservices in a preventive way, or when a child is sick or injured, thereby affect-ing the health and nutritional status of children (Alderman et al. 2013). Deficiencies in micronutrients such as vitamin A, iodine, iron, and zinc can cause irreversible deficits in the physical and mental development of children. Fortification of staples foods and salt iodization help prevent such deficien-cies, while reducing the risk of low-birthweight babies and child mortality (Bhutta et al. 2013; Horton, Alderman, and Rivera 2008).

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• Accesstosafeandsanitationwaterareessentialforarangeofdevelopmentoutcomes, including child morbidity, malnutrition, and mortality (on links between water, sanitation, and child health, see, among many others, Dillingham and Guerrant 2004; Esrey 1996; Esrey et al. 1991; Fay et al. 2005; Hutton and Haller 2004; Jalan and Ravallion 2003; Kosek, Bern, and Guerrant 2003; Moe and Rheingans 2006; Alderman et al. 2013; Bhutta, Ahmet, and Black 2008; Cairncross, Hunt, and Boisson 2010; World Bank 2010; Zwane and Kremer 2007; and Spears, 2013).

• AsnotedamongothersbyHortonetal.(2010),adequatehygieneandhandwashing may reduce the incidence of diarrhea by one third to half and there-by have a major impact on the health and nutrition status of children.

Table 3.1 provides data on the coverage of the various interventions in the latest available household survey, as well as changes in coverage between 2002 and 2012 (for some of the interventions discussed in this chapter, the change in coverage is computed between 2007 and 2012). Data are available for 7 of the 12 interven-tions. For several interventions, coverage is relatively high, at greater than 60 per-cent nationally. This is the case for the use of any contraceptive method, adequate treatment for acute respiratory infection, adequate treatment for fever, micronu-trients (vitamin A and iron) for children, and the safe disposal of children’s stools. But for some other interventions, especially key support for mothers, including the share of women who has completed at least secondary education and the share of women with health insurance offered by social security, coverage is low.

Table 3.2 also provides data on changes over time in the coverage of the inter-ventions. For some interventions, there has been a large gain in coverage over the last decade. This is the case for adequate treatment for acute respiratory infec-tion, adequate treatment for fever, access to improved sanitation, and the safe disposal of children’s stools. For other interventions, there seems to have been a decline or stagnation in coverage rate, with the largest decline suggested for vita-min A supplement for children. There has been a decline in improved drinking water, which is a bit surprising, given the substantial gain in improved sanitation.

Finally, the table provides data on the minimum and maximum values of the indicators, as well as the changes in indicators, between provinces (the full data are available in Heejin Kim and Wodon 2014; here only summary findings are reported). Clearly, there are very large differences between provinces in the level of coverage for virtually all interventions. For all the interventions listed in table 3.2, the average gap in coverage between the least and best performing provinces is 43.7 percentage points. The largest gap is at 59.3 points for access to improved sanitation, while the smallest gap is 30.8 points for secondary education completion.

Pregnancy and Birth PackagesThe second and third packages of essential interventions suggested by Denboba et al. (2014) are the pregnancy and birth packages. The pregnancy package covers the time from conception to birth while the birth package covers the time from

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Table 3.2 Coverage of Interventions in the Family Support Package

Intervention

By province

DHS indicator National Min Max

Coverage in 20121. Maternal education Female education (secondary completion) 23.4 13.0 43.8

2. Family planning and spacing

Use of any contraceptive method 61.9 21.8 70.3

Use of any modern contraceptive method 57.9 19.1 66.4

Media exposure to family planning messages 45.3 17.7 72.9

8. Access to health care Female health insurance coverage 25.7 7.2 60.7

Problem in accessing health care 34.1 25.7 64.0

Adequate treatment for acute respiratory illness 75.3 53.7 100.0

Adequate treatment for fever 73.5 52.0 84.1

9. Micronutrients Vitamin A supplement for children 61.1 32.0 74.7

Consumed foods rich in iron for children 67.5 50.8 78.3

10. Access to safe water Access to improved drinking water 41.1 17.8 58.6

11. Adequate sanitation Access to improved sanitation 57.8 25.1 84.4

12. Hygiene and hand washing

Hand washing 34.6 11.9 49.0

Safe disposal of children’s stools 79.7 34.2 94.7

Change in coverage (2002–12, unless indicated otherwise)

1. Maternal education Female education (secondary completion) 7.6 4.1 15.2

2. Planning for family size and spacing

Use of any contraceptive method 1.6 −5.9 13.1

Use of any modern contraceptive method 1.2 -4.0 13.3

Media exposure to family planning messages −2.7 −36.4 25.3

8. Access to health care Female health insurance coverage — — —

Problem in accessing health care −2.0 −21.1 29.2

Adequate treatment for acute respiratory illness 18.5 −7.0 38.6

Adequate treatment for fever 16.7 −12.4 27.2

9. Micronutrients Vitamin A supplement for children −14 −28.9 7.1

Consumed foods rich in iron for childrena −2.2 −25.3 10.8

10. Access to safe water Access to improved drinking water −6.6 −39.6 36.5

11. Adequate sanitation Access to improved sanitation 22.2 7.1 34.8


Hand washing — — —

Safe disposal of children’s stools 13.3 -4.4 31.6

Source: 2012 IDHS.a. Change over time is measured between 2007 and 2012. — = not available.

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birth to six months of age. Each of the two packages includes three main interventions. The combined six interventions, numbered 13–18, are (13) antenatal visits; (14) iron and folic acid for pregnant mothers; (15) counseling on adequate diet during pregnancy; (16) attended delivery; (17) birth registration; and (18) exclusive breastfeeding. Again, these various interventions tend to have high ben-efits and thereby also high returns. Examples of such benefits/returns are as follows:

• Antenatalvisits:Thesevisitsprovideopportunitiesforhealthcareprovidersto deliver a package of services including screening tests, counseling on re-duced workload, treatment for identified complications, and behavior-change communication to increase women’s skills in identifying danger signs and po-tential complications. The United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) recommend a minimum of four antena-tal care visits during pregnancy. Parenting education for expectant mothers is also important to cater future mothers with key parenting skills to improve outcomes for newborns. Antenatal visits reduce the risk of maternal and neo-natal death (UNICEF 2009).

• Iron and folic acid for pregnant mothers: Nearly one-quarter of maternaldeaths are caused by hemorrhages, which are closely linked to anemia during pregnancy (Black, Victora, and Walker 2013). Iron and folic acid supplemen-tation for pregnant women can reduce anemia as well as the risk of low-birthweight babies.

• Counselingonadequatedietsforpregnantmothers:Undernutritionduringpregnancy can affect fetal growth and development. An estimated 800,000 newborn deaths each year can be attributed to the increased risk associated with fetal growth restriction (Black, Victora, and Walker 2013). Counseling women on healthy diets and lifestyles during pregnancy can help to ensure that they have an adequate diet, including nutrient-rich food.

• Skilledattendantsatdelivery:Mostofthedirectcausesofmaternalmortalityrelated to obstetric complications can be addressed if skilled health personnel are present during delivery and referral facilities are available. Skilled attend-ed delivery can address the risks of birth defects and maternal mortality.

• Birthregistration:Worldwide,asmanyasoneinthreechildrenyoungerthanfive years of age are not currently registered (UNICEF 2012). Birth registra-tion is a first step to reach children with the services they need to fully de-velop. Some form of birth registration is generally required for children to obtain a birth certificate and access to services, protection and opportunities throughout life.

• Exclusivebreastfeeding:Followingearlyinitiationofbreastfeedingwithinonehour of birth, exclusive breastfeeding for the first six months contributes to a child’s short- and long-term health and development through the provision of rich nutritional inputs and positive socioemotional interaction between mother and child (Nelson 2007), as well as avoiding diseases caused by con-tact with contaminated food or water. Promotion of exclusive breastfeeding is

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one of the most promising interventions for improving child survival in the first six months of life.

Table 3.3 provides the data on coverage levels and changes in coverage over time. Data are available for all six interventions. Coverage tends to be higher for many of these interventions than was the case for the family support package, reaching 95.7 percent in the case of antenatal care.1 The lowest coverage rates, all at just below or above half of the population being covered, are for consulta-tions in the case of pregnancy complications, vitamin A supplements during pregnancy, counseling on diet during the pregnancy, birth registration, and breastfeeding within the first hour. In terms of changes over time in coverage,

Table 3.3 Coverage of Interventions in the Pregnancy and Birth Packages

Intervention DHS indicator National Min Max

Coverage in 2012

13. Antenatal care Antenatal care 95.7 57.8 99.3

Consultation on pregnancy complications 53.0 27.9 66.5

14. Iron and folic acid for pregnancy

Vitamin A supplement for pregnancy

48.1 29.7 60.7

Iron for pregnant mothers 75.5 31.9 96.6

15. Counseling on diet for pregnancy

Counseling on diet for pregnancy 52.8 21.8 76.3

16. Skilled attendance at delivery

Delivery attended by skilled personnel 83.1 39.9 98.7

Delivery in a health facility 63.2 16.7 98.4

17. Birth registration Birth registration 47.7 20.2 82.0

18. Exclusive breastfeeding

Breastfeeding within the first hour 49.3 17.1 73.7


13. Antenatal care Antenatal care 4.2 −1.7 21.9

Consultation on pregnancy complications 24.3 −1.6 39.9

14. Iron and folic acid for pregnancy

Vitamin A supplement for pregnancy 5.6 −10.9 23.3

Iron for pregnant mothers −2.9 −20.1 14.2

15. Counseling on diet for pregnancy

Counseling on diet for pregnancy 17.8 −36.7 39.0


Delivery attended by skilled personnel 16.8 0.1 31.6

Delivery in a health facility 23.5 4.3 47.1

17. Birth registration Birth registration 3.6 −21.0 23.0

18. Exclusive breastfeeding

Breastfeeding within the first hour 10.6 −20.3 41.1

Source: 2012 IDHS.

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there have been gains for all interventions except for iron for pregnant mothers. In some cases the gains have been large (above 20 points) and in other cases smaller. But as for the family support package, there are again large differences between provinces in coverage. For all the interventions listed in table 3.3, the average gap in coverage between the least and best performing provinces is 54.3 percentage points. The largest gap is at 81.7 points for delivery in a health facil-ity, and the smallest is at 31.0 points for vitamin A supplement during the pregnancy.

Child Health and DevelopmentThe fourth package of essential services is the child health and development pack-age which covers the time from birth to six years of age. The main risks of not providing essential services during this period are stunted growth, anemia, impaired cognitive development, and child mortality. The package consists of six main inter-ventions or services numbered 19–23: (19) immunizations; (20) adequate, nutri-tious, and safe diet; (21) therapeutic zinc supplementation for diarrhea; (22) pre-vention and treatment of acute malnutrition; and (23) deworming. Examples of such benefits or returns mentioned by Denboba et al. (2014) are as follows:

• Immunizations:Startingatbirth,acompletecourseofchildhoodimmuniza-tions is essential in reducing child morbidity and mortality. According to the WHO, increasing coverage of PCV, Rota, and Hib vaccine could have pre-vented 1.5 million deaths of children younger than five years of age in 2002 (Barnighausen et al. 2009). According to the Copenhagen Consensus, ex-panded immunization coverage for children is among the top ten most pro-ductive investments for countries.

• Adequate,nutritious,andsafediet:Aftersixmonthsofexclusivebreastfeed-ing, mothers should continue to breastfeed through 24 months while provid-ing complementary feeding with age-appropriate amounts, frequency, consis-tency, and variety of safely prepared foods. Responsive feeding practices are important, as is adequate feeding during and after illness. After two years, young children continue to need adequate, nutritious, and safe diets. Under-nutrition leads to weakened immune systems of babies and young children, putting them at a greater risk of falling sick from preventable illnesses like pneumonia and diarrhea. Nearly one-fifth of deaths of children younger than five years of age could be prevented with optimal feeding (UNICEF 2009).

• Therapeuticzinc supplementation fordiarrhea:Approximately1.5millionchildren in the developing world die from diarrhea each year. Therapeutic zinc supplementation can reduce deaths from diarrhea by almost one quarter (UNICEF 2009).

• Preventionandtreatmentofacutemalnutrition:Proveninterventionsincludecomplementary and therapeutic feeding to provide micronutrient-fortified and/or enhanced complementary foods for the prevention and treatment of moder-ate malnutrition among children 6–23 months of age and community-based

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management of severe acute malnutrition among children younger than five years of age. Community-based management of acute malnutrition includes (a) in-patient care for children with severe acute malnutrition with medical com-plications and infants younger than six months of age with visible signs of severe acute malnutrition; (b) out-patient care for children with severe acute malnutri-tion without medical complications; and (c) community outreach (Horton et al. 2010).

• Deworming:Worminfectionsareachronicconditionthataffectchildren’shealth, nutrition, and development and, as a consequence, limit their ability to access and benefit from education. Worms can cause children to become anemic and malnourished and can impair their mental and physical develop-ment (Hotez et al. 2006). Deworming is simple, safe, and inexpensive and has beneficial effects on educational outcomes.

Table 3.4 provides the data on coverage levels and changes in coverage over time. Data are available for all five interventions. For a few interventions, cover-age is again relatively high, at above 60 percent nationally, although this is still not high enough for relatively simple interventions such as immunizations. The lowest coverage rate is for deworming medication for children, at only a quarter of the target group covered. In terms of changes over time in coverage, there have been gains for all interventions for which data are available, which is good news even though some of the gains are small in comparison to the remaining gaps. In

Table 3.4 Coverage of Child Health and Development Interventions


Coverage in 201219. Immunizations Immunization (DPT3) 72.0 35.3 96.4

Immunization (measles) 80.1 49.0 97.1

20. Adequate, nutritious, and safe diet

Adequate diet for children 36.6 16.3 55.5

21. Therapeutic zinc supplementationfor diarrhea

Adequate treatment for diarrhea 64.6 45.3 81.6

Oral rehydration therapy for diarrhea 46.8 31.4 73.3

23. Deworming Deworming medication for children 25.9 6.6 34.8


19. Immunizations Immunization (DPT3) 13.7 −4.4 26.1

Immunization (measles) 8.5 −5.9 17.4


Adequate diet for childrena −4.6 −24.4 13.0

21. Therapeutic zinc supplementationfor diarrhea

Adequate treatment for diarrhea 16.8 −24.7 39.1

Oral rehydration therapy for diarrhea 8.5 −4.7 36.1

23. Deworming Deworming medication for children — — —

Source: 2012 IDHS.Note: DPT = diphtheria, pertussis, and tetanus. a. Change over time is measured between 2007 and 2012.

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terms of differences between provinces, the average gap in coverage between the least and best performing provinces is 42.5 percentage points, with the largest gap observed for immunization (DPT3) at 61.1 points and the smallest gap observed for deworming medication for children at 28.2 points, in part because coverage remains relatively low for all provinces for that intervention.

Schooling InterventionsThe last and fifth package of essential ECD interventions outlined by Denboba et al. (2014) is the preschool package, which covers the period from three to six years of age. The quality of a child’s early learning experience makes a sig-nificant difference to school preparation, participation, completion, and achievement. Without adequate early childhood education, young children may not have the necessary skills to fully benefit from the education they receive at the primary level. The preschool package consists of two interven-tions/services, which, given the interventions, are numbered 24 and 25, (24) early childhood and preprimary programs, and (25) continuity to quality pri-mary education. As reviewed in Denboba et al. (2014), and as was the case for other interventions reviewed in this chapter, these two interventions tend to have high benefits/returns. Examples are as follows:

• Preprimaryeducation:Youngchildrenneed sustainedaccess to supportive,nurturing environments that provide a high degree of cognitive stimulation and emotional care throughout the early years (UNESCO 2014). Compared to children who attend quality preprimary programs, children who enter school without adequate preparation are more likely to have poor academic performance, repeat grades, and drop out of school (Currie and Thomas 1999; Feinstein, 2003; Heckman and Masterov 2007; Reynolds et al. 2001). Beyond access, quality in preprimary education is equally critical. Children will only benefit from increased access to early childhood care and education (ECCE) if the services provided meet core quality standards. Quality preprimary pro-grams are linked to lifelong benefits for individuals and society at large. They reduce the need for remedial education or rehabilitative actions later on, in-cluding in terms of reducing the risk of incarceration and improving welfare in adulthood (Schweinhart et al. 2005).

• Continuity to primary school: During the period of time when childrenmove from either home or an early childhood program into primary school, they experience demanding changes (Arnold et al. 2006; Fabian and Dunlop 2007). For the transition to be smooth, children need to be ready for school and, equally important, schools need to be ready for children (Consultative Group on EECD 1991; Myers and Landers 1989). Evidence suggests that the failure of the first year or two of school to establish basic literacy skills creates inefficiencies that reverberate through a child’s progression through the education system (Abadzi 2006). Young children should possess the school readiness skills necessary—physical health and well-being, social

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competence, emotional maturity, language and cognitive development, communication skills, and general knowledge—to be able to learn effectively in school (Janus and Offord 2000). Ensuring continuity between early child-hood and primary years is important to counter potential fade-out of the impact of preschools in primary school. Quality improvement in early pri-mary grades (integrating ECCE/early primary experience, teacher training on classroom strategies for young children, and smaller class size) can im-prove learning outcomes, school attendance, pass rates, and promotions and reduce dropout and repetition rates (Arnold et al. 2008). Well-trained and high-quality experienced teachers in the early grades of primary school can help close the readiness gaps that young children may face (Pianta, Laparo, and Hamre 2007; Schady et al. 2014).

Table 3.5 provides the data on coverage levels and changes in coverage over time. Data are available for both interventions. Enrollment rates are very low for preschools, whether one considers the age group of three and four years or that of children five or six years old, although as was to be expected, coverage is higher for the older age group. By contrast, net enrollment rates in primary school are high. In terms of changes over time in coverage, there has been a substantial gain for preschool enrollment which has nearly doubled between 2007 and 2012, but the net enrollment rate in primary school has decreased. This may however not necessarily be a negative outcome if it denotes that fewer students are too old for their grade. As always, the differences between provinces are large, with the average gap in coverage between the least and best performing provinces being at 44.7 percentage points for the three interventions listed, and larger than that for preschool enrolment among five- or six-year-olds.

Comparing Coverage Rates and Changes in Coverage RatesFigures 3.2 and 3.3 provide a visual summary of the data on coverage and changes in coverage over time. In figure 3.2, interventions are ranked by level of

Table 3.5 Coverage of Education Interventions


Coverage in 201224. Preprimary education Net enrollment rate in preprimary education (ages 3–4 years) 15.3 3.6 45.2

Net enrollment rate in preprimary education (ages 5–6 years) 32.6 7.5 74.8

25. Continuity to primary Net enrollment rate in primary education (ages 7–12 years) 92.5 70.8 96.0


24. Preprimary education Net enrollment rate in preprimary education (ages 3–4 years)a 5.3 −3.4 21.9

Net enrollment rate in preprimary education (ages 5–6 years)a 14.7 −0.9 35.9

25. Continuity to primary Net enrollment rate in primary education (ages 7–12 years)a −1.3 −10.2 2.6

Source: SUSENAS 2007, 2012 databases and BPS Indonesia Statistics.a. Change over time is measured between 2007 and 2012.

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Figure 3.2 Coverage of Essential Early Childhood Development Interventions, 2012

Ch

ild d

evel

opm

ent

and

ed

uca

tion

pac

kag

es


Preg

nan

cy a

nd

bir

th s

up

por

tp

acka

ges

0 10 20 30 40 50 60 70 80 90 100

Antenatal care


Iron for pregnant mothers

Delivery in a health facility

Consultation on pregnancy complications

Counseling on diet for pregnancy



Birth registration

Fam

ily s

up

por

t pac

kag

e

0 10 20 30 40 50 60 70 80 90 100

Hand washing

Adequate treatment for acute respiratory infection

Adequate treatment for fever

Consumed foods rich in iron for children

Use of any contraceptive method




Media exposure to family planning messages


Safe disposal of children’s stools

Problem in accessing health care

Female health insurance coverage


0 10 20 30 40 50 60 70 80 90 100

Net enrollment rate in primaryeducation (ages 7–12 years)

Immunization (Measles)

Net enrollment rate in preprimaryeducation (ages 5–6 years)


Net enrollment rate in preprimaryeducation (ages 3–4 years)

Immunization (DPT3)

Adequate treatment for diarrhea



Source: 2012 IDHS.

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Figure 3.3 Change in Coverage over Time (2002–12, Unless Indicated Otherwise)


Adequate treatment for acuterespiratory infection







Consumed foods rich in iron for childrena






Counseling on diet for pregnancy




Antenatal care

Birth registration


−50 −40 −30 −20 −10 0 10 20 30 40 50


Net enrollment rate in preprimary(ages 5−6 years)a

Immunization (DPT3)

Immunization (measles)


Net enrollment rate in preprimary(ages 3−4 years)a

Net enrollment rate in primary(ages 6−12 years)a

Adequate diet for childrena

−50 −40 −30 −20 −10 0 10 20 30 40 50

−50 −40 −30 −20 −10 0 10 20 30 40 50


Ch

ild d

evel

opm

ent a

nd

ed

ucat

ion

pac

kag

esPr

egn

ancy

an

d b

irth

sup

por

t pac

kag

esFa

mily

sup

por

t pac

kag

e

Source: 2002/03, 2007 and 2012 IDHS.a. Change over time is measured between 2007 and 2012.

58



coverage from the intervention with the most coverage to that with the least coverage. In figure 3.3, the same principle is applied, but the ranking is based on the size of the change in coverage. In both figures, the red dot represents the national coverage level, while the blue bar represents the difference between the least and best performing provinces for each indicator. Together the two figures provide a simple diagnostic of the level of coverage for the various types of inter-ventions, and the improvements in coverage over time or lack thereof, depending on the indicators.

Figure 3.2 underscores again the fact that there are today large differences in the coverage of various interventions, often with a gap of up to 50 percentage points between the provices with the lowest coverage and the provinces with the highest coverage. Figure 3.3 shows that it is not necessarily a given for cover-age to increase over time. For some interventions, there has been a decline in coverage between the various survey years. Some of this may be related to dif-ferences in survey coverage between years. In addition, it should be kept in mind that all estimates are based on survey data, so that the estimates have standard errors, and these are larger at the level of individual provinces than at the level of the country as a whole, given the smaller sample size at the level of individ-ual provinces. But at the same time, there is also evidence of losses in coverage for some intervntions, including at the national level. This is more the case for interventions in the family support package than for the interventions in other opackages. A more detailed analysis of changes in coverage over time is available in a companion piece by Heejin Kim and Wodon (2015).

Coverage and Level of Economic Development

This last section provides a brief analysis of the relationship between the level of economic development of provinces and the coverage of the essential interven-tions. One would expect a positive relationship, but also substantial variability, with some poorer provinces at times performing better than richer ones. The extent to which the relationship between the coverage of interventions and the level of economic development is strong can be measured through the R2 value associated with a regression line through the scatter plot of coverage rates as a function of provincial gross domestic product (GDP) per capita. This can be done for each intervention separately.

The results are displayed in table 3.6. Figure 3.4 ranks the intervention according to the strength of those relationships. In general, the relationships are not very strong, suggesting that comparatively high coverage can be achieved even in provinces with low levels of GDP per capita. The highest R2 value is observed for the share of women who have completed secondary edu-cation, with GDP per capita explaining 44.5 percent of the variation in cover-age. The lowest R2 value is vitamin A supplement for children, use of any modern contraceptive method, and enrollment in primary education, which present virtually zero relationship (R2 values less than 0.100). In other words,

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Figure 3.4 Coverage of Early Childhood Development Interventions and Economic Development

0 0.1 0.2 0.3 0.4 0.5



Net enrollment rate in primary education (ages 7−12 years)






Immunization: Measles

Immunization: DPT3

Antenatal care


Fertility rates

Net enrollment rate in preprimary education (ages 3−4 years)



Net enrollment rate in preprimary education (ages 5−6 years)


Female education (primary completion)

Duration of exclusive breastfeeding

Under-five mortality

Hand washing





Infant mortality



Birth registration








R2

Source: 2012 IDHS.

provinces and the country as a whole cannot rely on economic growth to somehow lift up the coverage of the various interventions in a systematic way—specific policies and programs are required to increase coverage rates. This is also observed in figure 3.5, which displays the R2 values for the relation-ship between changes in GDP and change in coverage. These R2 values are typically smaller in differences than is the case in levels.

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Figure 3.5 Changes in Coverage of Early Childhood Development Intervention and Change in Economic Development (2002–12, Unless Indicated Otherwise)

0 0.05 0.1 0.15 0.2 0.25 0.3 0.35 0.4




Consumed foods rich in iron for childrena




Female education (primary completion)


Immunization (measles)

Antenatal care

Net enrollment rate in preprimary education (ages 5−6 years)a


Immunization (DPT3)

Net enrollment rate in preprimary education (ages 3−4 years)a

Under-five mortality


Net enrollment rate in primary education (ages 6−12 years)a


Infant mortality

Fertility rate

Birth registration





Duration of exclusive breastfeeding



Adequate diet for childrena





R2

Source: 2002/03, 2007, and 2012 IDHS and BPS Indonesia.a. Change over time is measured between 2007 and 2012.

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Conclusion

In the SABER-ECD framework, the second policy goal refers to the extent to which policies and programs are implemented widely—in terms of scope, cover-age, and equity. The objective of this chapter was to document in more details the coverage of essential ECD interventions with a focus on differences between provinces. The analysis focused on 25 essential interventions for young children grouped into five packages: the pregnancy, birth, child health, preschool, and family support packages. Information was available in the surveys for 19 of the 25 interventions considered, so the diagnostic provided was fairly comprehensive.

The diagnostic suggests major disparities in coverage between provinces. On average, across provinces, some services such as entry in primary school, antenatal care, access to health care have high coverage, while others such as maternal education (at least secondary), preprimary education, birth registration have low coverage. But the averages mask very large coverage differentials between prov-inces, often at 40–50 percentage points per intervention.

Note

1. Antenatal care refers to the percentage of women ages 15–49 years who had a live birth in the five years receiving antenatal care (four visits) from a skilled provider (doctor, obstetrician, nurse, midwife, and village midwife) for the most recent birth. However, this figure does not consider the timing of antenatal checks as recom-mended by WHO (1–2 visits at first, second, and third trimesters, respectively). The Basic Health Profile 2013 (RISKESDAS 2013) indicates that the national average of the antenatal check that takes into consideration the timing of antenatal checks was 70.4 percent.

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6

3

Annex 3A

Table 3A.1 Description of Indicators Used to Measure Coverage

Intervention DHS indicator Description

1. Maternal education Female education (primary/secondary completion)

Percent distribution of women ages 15–49 years, by highest level of schooling completedPrimary completion: completed sixth grade at the primary levelSecondary completion: completed sixth grade at the secondary level


Fertility rates Total fertility rate, the percentage of women ages 15–49 years who are currently pregnant, and the mean number of children ever born to women ages 40–49 years


Percent distribution of currently married women ages 15–49 years by contraceptive method currently usedAny traditional method: rhythm, withdrawal, otherAny modern method: female sterilization, male sterilization, pill, intrauterine device, injectable, implants, male con-

dom, diaphragm (intravag), lactational amenorrhea, emergency contraception


Percentage of currently married women ages 15–49 years who heard or saw a family planning message on television in the past few months

8. Access to healthcare Infant/under-five mortality Total number of deaths per 1,000 live birthsInfant mortality: the probability of dying between birth and exactly age one yearUnder-five mortality: the probability of dying between birth and exactly age five years


Percentage of women ages 15–49 years with health insurance coverage offered by social security


Percentage of women ages 15–49 years who reported that they have serious problems in accessing health care for themselves when they are sick


Among children younger than five years of age, the percentage who had symptoms of acute respiratory infection in the two weeks preceding the survey and among children with symptoms of acute respiratory infection, the percentage for whom advice or treatment was sought from a health facility or provider

Adequate treatment for fever Among children younger than five years of age, the percentage who had a fever in the two weeks preceding the survey; and among children with fever, the percentage for whom advice or treatment was sought from a health facility or provider

9. Micronutrient supplementation and fortification


Among all children 6–59 months, the percentages who were given vitamin A supplements in the six months preceding the survey


Among youngest children ages 6–23 months who are living with their mother, the percentages who consumed iron-rich foods in the day or night preceding the survey


64


10. Access to safe water


Percent distribution of households and de jure population with improved source of drinking water

11. Adequate sanitation


Percent distribution of households and de jure population having improved with improved sanitation facilities


Hand washing Percentage of households in which the place for hand washing was observed


Percent distribution of youngest children younger than five years of age living with the mother by the manner of dis-posal of the child’s last fecal matter, and percentage of children whose stools are disposed of safely using toilet/latrine

13. Antenatal care Antenatal care Percentage of women ages 15–49 years who had a live birth in the five years receiving antenatal care from a skilled provider (doctor, obstetrician, nurse, midwife, and village midwife) for the most recent birth


Among women ages 15–49 years who received antenatal care for their most recent birth in the past five years, the percentage of women who informed of sings of pregnancy complications

14. Iron and folic acid for pregnant mothers

Iron for pregnant mothers Among women with a live birth in the past five years, the percentage who took iron tablets or syrup during the pregnancy of their last birth

15. Counseling on adequate diet for pregnant mothers


Percentage of last births in the two years preceding the survey whose father discussed with a health care provider about the type of foods the mother eats during pregnancy



Percentage of live births in the five years preceding the survey assisted by a skilled provider (doctor, obstetrician, nurse, midwife, and village midwife)

Delivery in a health facility Percentage of live births in the five years preceding the survey who delivered in a health facility

17. Birth registration Birth registration Percentage of the de jure population younger than five years of age whose births are registered with the civil authorities

18. Exclusive breast-feeding


Among last-born children who were born in the two years preceding the survey, the percentages who started breastfeeding within one hour

Duration of exclusive breast-feeding

Median duration of exclusive breastfeeding among children born in the three years preceding the survey

19. Immunizations Immunization (DPT3/ measles)

Percentage of children age 12–23 months who received specific vaccines at any time before the survey, according to a vaccination card and the mother’s report


Table 3A.1 Description of Indicators Used to Measure Coverage (continued)

6

5



Adequate diet for children Among all children age 6–23 months living with their mother, percentage of youngest children who are fed accord-ing to three infant and young child feeding feeding practices, including timely initiation of feeding solid/semisolid foods from age 6 months, feeding small amounts, and increasing the amount of foods and frequency of feeding as the child gets older, while maintaining frequent breastfeeding

21. Therapeutic zinc supplementation for diarrhea


Among children younger than five years of age who had diarrhea in the two weeks preceding the survey, the per-centage for whom advice or treatment was sought from a health facility or provider


Among children younger than five years of age who had diarrhea in the two weeks preceding the survey, the percentage given oral rehydration therapy, including fluid from oral rehydration salts packets or prepackaged liquid or recom-mended home fluids

23. Deworming Deworming medication for children

Among youngest children age 6–23 months who are living with their mother, the percentages who were given deworming medication in the six months preceding the survey

24. Preprimary education

Net enrollment rate in preprimary education

The number of children enrolled in preprimary school who belong to the age group that officially corresponds to preprimary schooling, divided by the total population of the same age group

25. Continuity to primary

Net enrollment rate in primary education

The number of children enrolled in primary school who belong to the age group that officially corresponds to pri-mary schooling, divided by the total population of the same age group

Source: IDHS and SUSENAS surveys.Note: DPT = diphtheria, pertussis, and tetanus.

Table 3A.1 Description of Indicators Used to Measure Coverage (continued)



Table A.2 Relation between Coverage Levels and Economic Development

Intervention DHS indicator R2

1. Maternal education Female education (primary completion) 0.107

1. Maternal education Female education (secondary completion) 0.445


Fertility rates 0.067

Use of any contraceptive method 0.021

Use of any modern contraceptive method 0.012

Media exposure to family planning messages 0.180

8. Access to healthcare Infant mortality 0.183

Under-five mortality 0.121

Female health insurance coverage 0.380

Problem in accessing health care 0.079

Adequate treatment for acute respiratory infection 0.134

Adequate treatment for fever 0.145


Vitamin A supplement for children 0.007

Consumed foods rich in iron for children 0.204

10. Access to safe water Access to improved drinking water 0.262

11. Adequate sanitation Access to improved sanitation 0.282

12. Hygiene and hand washing Hand washing 0.132

Safe disposal of children’s stools 0.137

13. Antenatal care Antenatal care 0.044

Consultation on pregnancy complications 0.092


Vitamin A supplement for pregnant mothers 0.032

Iron for pregnant mothers 0.021

15. Counseling on diet for pregnancy Counseling on adequate diet for pregnant mothers 0.200

16. Skilled attendance at delivery Delivery attended by skilled personnel 0.245

Delivery in a health facility 0.256

17. Birth registration Birth registration 0.220

18. Exclusive breastfeeding Breastfeeding within the first hour 0.080

Duration of exclusive breastfeeding 0.114

19. Immunizations Immunization (DPT3) 0.041

Immunization (measles) 0.039

20. Adequate, nutritious, and safe diet Adequate diet for children 0.226


Adequate treatment for diarrhea 0.023

Oral rehydration therapy for diarrhea 0.018

23. Deworming Deworming medication for children 0.055

24. Preprimary education Net enrollment rate in preprimary education (age 3–4) 0.071

Net enrollment rate in preprimary education (age 5–6) 0.082

25. Continuity to primary Net enrollment rate in primary education (age 7–12) 0.015

Highest R2 Female education (secondary completion) 0.445

Lowest R2 Vitamin A supplement for children 0.007

Source: 2012 IDHS and BPS Indonesia.Note: DPT = diphtheria, pertussis, and tetanus.

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Table A.3 Relation between Change in Coverage Levels and Change in Economic Development

Intervention DHS indicator R2

1. Maternal education Female education (primary completion) 0.021

Female education (secondary completion) 0.338

2. Planning for family size and spacing Fertility rates 0.070

Use of any contraceptive method 0.004

Use of any modern contraceptive method 0.033

Media exposure to family planning messages 0.017

8. Access to healthcare Infant mortality 0.063

Under-five mortality 0.040

Problem in accessing health care 0.202

Adequate treatment for acute respiratory infection 0.053

Adequate treatment for fever 0.062


Vitamin A supplement for children 0.175

Consumed foods rich in iron for childrena 0.008

10. Access to safe water Access to improved drinking water 0.024

11. Adequate sanitation Access to improved sanitation 0.126

12. Hygiene and hand washing Safe disposal of children’s stools 0.121

13. Antenatal care Antenatal care 0.027

Consultation on pregnancy complications 0.002


Vitamin A supplement for pregnant mothers 0.100

Iron for pregnant mothers 0.007

15. Counseling on diet for pregnancy Counseling on adequate diet for pregnant mothers 0.118

16. Skilled attendance at delivery Delivery attended by skilled personnel 0.019

Delivery in a health facility 0.233

17. Birth registration Birth registration 0.070

18. Exclusive breastfeeding Breastfeeding within the first hour 0.015

Duration of exclusive breastfeeding 0.122

19. Immunizations Immunization (DPT3) 0.034

Immunization (measles) 0.025

20. Adequate, nutritious, and safe diet Adequate diet for childrena 0.146


Adequate treatment for diarrhea 0.098

Oral rehydration therapy for diarrhea 0.141

24. Preprimary education Net enrollment rate in preprimary education (ages 3–4 years)a

0.036

Net enrollment rate in preprimary education (ages 5–6 years)a

0.031

25. Continuity to primary Net enrollment rate in primary education (ages 7–12 years)a

0.061

Highest R2 Female education (secondary completion) 0.338

Lowest R2 Consultation on pregnancy complications 0.002

Source: 2002/03, 2007, and 2012 IDHS and BPS Indonesia.a. Change over time is measured between 2007 and 2012. DPT = diphtheria, pertussis, and tetanus.

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Lindsay Adams, Amina Denboba, Rebecca Sayre, Titie Hadiyati, Djoko Hartono, Janice Heejin Kim, Amer Hasan, Rosfita Roesli, Mayla Safuro, and Quentin Wodon

C H A P T E R 4

District-Level SABER-ECD Assessments

Abstract

In chapter 2, the Systems Approach for Better Education Results-Early Childhood Development (SABER-ECD) tool was applied at the national level for Indonesia. But substantial decentralization has taken place, with districts now being in charge of the implementation of a number of policies and programs related to early childhood development (ECD). It is therefore useful to also look at the results of the implementation of SABER-ECD tool at the district level. This is done in this chapter for five illustrative districts in order to document differences in policies and programs between districts.

Introduction

While assessing ECD policies at the national level is very important, it may not be sufficient, given that substantial decentralization leads to many decisions being made at lower administrative levels instead of centrally. In Indonesia, dis-tricts have a key role in the implementation of ECD programs and policies. It is therefore useful to also look at the results of the implementation of SABER-ECD tool at the district level. This cannot be done for all districts as part of this study, given that there over 400 of of them. But it can be done for a few districts as illustrative cases of potential differences in policies and programs between districts. The districts focused on in this chapter were selected in consultation with Bappenas to reflect a range of implementation arrangements and capacity.

For this chapter, data were collected in five districts or regencies: Kapuas in Central Kalimantan Province, Manggarai Timur in East Nusa Tenggara province, Pacitan in East Java Province, Sukabumi in West Java Province, and Sumbawa in West Nusa Tenggara Province. Data at the district level on economic develop-ment tend not to be available, but data are available at the provincial level. As shown in table 4.1, to the extent that the various districts are illustrative of the

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70 District-Level SABER-ECD Assessments


standards of living in their broader province, two of the districts, Pacitan and Kapuas, tend to be relatively well off, while Sukabumi is located in a province with an average level of gross domestic product (GDP) per capita. The last two districts, Manggarai Timur and Sumbawa, are located in poorer provinces. One would then expect—and this is indeed observed—that levels of coverage of key ECD interventions would tend to be higher in the districts located in the better-off provinces.

The chapter provides the results of the application of the SABER-ECD diag-nostic tool to the five districts (see chapter 2 for the application of the tool at the national level). The structure of the chapter is as follows. Given that the SABER-ECD framework has already been presented in chapter 2, each of the next three chapters is devoted to a policy goal. A conclusion follows.

Establishing an Enabling Environment

As shown in table 4.2, the five districts are rated at the same level (emerging) in terms of their policies related to establishing an enabling environment. District ratings are slightly less than those observed for Indonesia as a whole, but differ-ences are small as shown in figure 4.1. In that figure, as well as in many others that follow, the districts are ranked on the horizontal axis according to the level of GDP per capita of the province in which they are located. There is a presump-tion that for some of the indicators—including those related to finance and the coverage of various programs—richer areas tend to perform better than poorer areas. When considering policy frameworks, this is not necessarily the case, but when considering which interventions actually reach the target population, richer areas typically do perform better. Note also that while normalized ratings are provided in tables (taking a value of one to four), the actual ratings obtained

Table 4.1 Basic Statistics at Provincial Level

Province (district)Provincial population

at 2010 CensusProvincial area (km2)

Provincial population density

per km2

GDP per capita (PPP, current

international $)

Provinces with one of the five districtsEast Java (Pacitan) 37,476,757 47,799 828 10051.6

West Java (Sukabumi) 43,053,732 35,377 1176 7917.0

Central Kalimantan (Kapuas) 2,212,089 153,564 14 9257.7

West Nusa Tenggara (Sumbawa) 4,500,212 18,572 234 4434.9

East Nusa Tenggara (Manggarai Timur) 4,683,827 48,718 92 2877.7

Country average — — — 9558.8

Source: Based on the 2012 DHS report, BPS-Statistics Indonesia, and the World Development Database.Note: GDP = gross domestic product; PPP = purchasing power parity; — = not applicable.

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District-Level SABER-ECD Assessments 71


Table 4.2 Enabling Environment Policy Goal and Levers

Policy goal Levers

Enabling environment Legal framework

Intesectoral coordination Finance

Indonesia district

Kapuas 2 2 1 3

Manggarai Timur 2 2 1 3

Pacitan 2 2 2 3

Sukabumi 2 2 3 2

Sumbawa 2 2 3 2

All five districts 2 2 2 2.6

Countries

Indonesia 3 3 3 3

All countries 2.1 2.4 1.9 2.1

Note: Each number indicates the level of development in early childhood development policy at the corresponding level. “1”= latent, “2”= emerging, “3”= established, and “4” = advanced.

Figure 4.1 Ratings for Enabling Environment Policy Goals

Indonesia

Kapuas

PacitanSukabumiSumbawa

R2 = 0.40281.0

1.5

2.0

2.5

3.0

3.5

4.0

0 2,000 4,000 6,000 8,000 10,000 12,000GDP per capita, PPP (current international $)

Manggrai Timur

Note: GDP = gross domestic product; PPP = purchasing power parity.

from responses to a range of questions are displayed in the figures, so that even when two districts have the same normalized rating, there can still be differ-ences in actual ratings.

In the case of the enabling environment policy goal, differences between dis-tricts tend to be small. This should not be too surprising, given that many of the policies related to the enabling environment—such as the legal framework—tend

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to be decided at the national level, and this may actually result in some cases in lower ratings at the district than at the national level. But there are nevertheless some differences between districts in ratings. In what follows, we discuss the find-ings for the various districts for each of the three policy levers.

Legal FrameworkConsider first the legal framework, where, as shown in figure 4.2, differences between districts are small. This can be illustrated in the case of health services. By the time the data collection was held in five districts, the former insurance scheme for maternal health (Jaminan Persalinan, Jampersal) was still imple-mented. In all five districts, because of national-level policies, the government-funded maternal and baby health insurance scheme (Jampersal) covers the costs of antenatal care, childbirth and skilled delivery, postnatal care, and family planning services for all mothers and their babies. Young children receive a course of immunizations, and well-child visits are required at post natal periods, at least four times until 42 days after childbirth and periodic visits until five years of age. These well-child visits are provided free of charge at village health posts (Posyandu). Currently, the former insurance scheme has been replaced by the national health insurance scheme (Jaminan Kesehatan Nasional, JKN) cov-ering promotion, preventive, curative, and rehabilitative health services. While the health sector generally provides a good range of basic services, the system could be further strengthened to improve the provision of health services: required immunizations could be expanded to include vaccination for rubella, meningitis, and mumps; and quality health screenings for human immunodefi-ciency virus (HIV) and sexually transmitted diseases should available at all heath centers.

Figure 4.2 Ratings for Legal Framework Policy Levers

Indonesia

KapuasManggrai Timur PacitanSumbawa

1.0

1.5

2.0

2.5

3.0

3.5

4.0


R2 = 0.5273

Sukabumi


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While policies are relatively good in health, free preprimary education is not mandated, neither nationally nor in the five districts. While it may not be realistic at this point to require children to attend preprimary school free of charge, districts could consider this as a goal to work towards. Attending high-quality preprimary programs helps prepare children for future academic and social success and, more broadly, strengthens the economy and society. In the near term, expanding access to programs that teach parents how to promote their children’s development can be an effective way to foster learning at home, especially in poorer families.

Again, at the district level, there is in most cases no policy to mandate birth registration, as all districts defer to national policy on birth registration. The exception is Manggarai Timur, which mandates that all newborns be registered through the Office of Civil Registration within 60 days after delivery (District Regulation No. 1/2012 on Civil Registration).

Finally, and this is again observed in all five districts (as well as nationally), while some child and social protection services are established, these could be improved. But there have also been initiatives at the district level. For example, several districts have established integrated service centers for women and children to prevent domestic violence. In addition, district social affairs offices focus on advocacy and treatment of women and children affected by trauma. While this type of initiative is commendable, there is still room for improve-ment to strengthen social protection policies and services not only in Kapuas, but also in other districts.

Districts typically do not have policies to provide orphans and vulnerable chil-dren with ECD services. Furthermore, there are typically no laws or statutes in place to protect the rights of children with disabilities and promote their partici-pation and access to ECD services. However, in Pacitan the local government has established an inclusive education policy (District Regulation No. 38/2012 on Inclusive Education) to cater to the needs of young children with disabilities. The regulation defines children with special needs as children with different physical and/or mental disability, requiring special interventions for disorders such as sight, hearing, communication, physical, mental, socioemotional, and autism. The local government ensures that at least one early childhood care and education (ECCE) facility and one elementary school in every subdistrict are supported by teachers with special skills and have proper educative toys accessible to young children.

Intersectoral CoordinationConsider next intersectoral coordination (Fiugre 4.3) where there are more dif-ferences in the ratings for the five districts than was the case for the legal frame-work, as shown in figure 4.2. Sukabumi and Sumbawa are rated as established in terms of their intersectoral coordination mechanisms, Pacitan is rated as emerg-ing, and Kapuas and Manggarai Timur are rated as latent.

A key reason while the Kapuas and Manggarai Timur districts are rated as latent is that they do not appear to have an explicitly stated multisectoral ECD policy that would complement the national Holistic Integrated-Early Childhood

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Development (HI-ECD) policy. The two districts also have not established a district cross-sectoral ECD institutional anchor, even though the Manggarai Timur district is planning to initiate a pilot early childhood care and education (ECCE) project targeting children from birth to age six years that would pro-vide holistic ECD services including early stimulation, health, nutrition, and parenting services. This project will be implemented through multisectoral agreement between the relevant sectors, as well as integrated budget framework. Lessons learned from this initiative could serve as a basis for the development of a holistic and integrated ECD system in Manggarai Timur, including all rele-vant sectors (education, health, nutrition, and child and social protection) and targeting the most vulnerable children.

By contrast, Sumbawa has an explicitly stated multisectoral ECD strategy. The Regent’s Decree on Holistic and Integrated ECD (Pospa BKB [HI-ECD]) policy was established in 2013 for children 0–72 months. The HI-ECD policy includes an implementation plan, and funding comes from local budget and community participation. The policy covers education, health, nutrition, and child protection. The HI-ECD could be reviewed to ensure that it covers social protection, which protects the most vulnerable children and their families. In addition, an institutional anchor has been established to coordinate ECD across sectors. The district planning and development agency (Badan Perencanaan dan Pembangunan Daerah, Bappeda) is the lead coordination body for ECD policy. In 2013, Bappeda formed the Taskforce of HI-ECD (Pospa BKB) as the cross-sectoral district ECD anchor. Members of the taskforce, including the district education office, district health office, district social affairs, family planning and women empowerment agency, district community empowerment and village governance, and the district religious affairs office are responsible for implemen-tation. The Pospa BKP provides general guidance on a list of integrated ECD services for young children, and detailed manuals for service delivery are

Figure 4.3 Ratings for Intersectoral Coordination Policy Lever

Indonesia

Pacitan

1.0

1.5

2.0

2.5

3.0

3.5

4.0


Polic

y Le

ver 2

: in

ter-

sect

oral

coo

rdin

atio

n

R2 = 0.6452 Kapuas

SukabumiSumbawa

Manggrai Timur


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provided by each of the leading sectors responsible for implementation of ECD services.

Similarly, Sukabumi has a HI-ECD policy that is multisectoral and encom-passes education, health, nutrition, and child protection. The policy does not yet cover social protection, a sector that includes issues such as services for orphans and vulnerable children and financial transfers or income supports for vulnerable families. It could be reviewed to ensure it aids the district’s most vulnerable chil-dren. The Bappeda (district planning and development agency) is the lead coor-dination body for ECD policy. Implementation is conducted by the district education office, district health office, district social affairs, family planning and women empowerment agency, district community empowerment and village governance, district religious affairs office, ECCE teacher associations, and civil society organizations. The ECD Forum and Women Group and other meetings between service providers and local government help to coordinate service deliv-ery. It is not fully clear whether the Bappeda has the resources and authority to fulfill its mandate as the ECD leader and coordination body.

Pacitan has a rating of emerging for intersectoral coordination. While a multisectoral ECD strategy has not yet been developed at the district level, the district follows the provincial strategy. The government is also implement-ing the HI-ECD (Taman Posyandu) based on East Java Provincial Government’s Regulation No. 63/2011 on HI-ECD. Since decentralization, the district gov-ernment has developed complementary ECD policies and programs funded through local budgets. While the education sector leads the ECD policy devel-opment, the Bappeda (district planning and development agency) leads coor-dination efforts at the implementation level. The multisectors stakeholders involved include district education office, district health office, district social affairs office, family planning and women empowerment agency (BP2KB), district community empowerment and village governance office (Bappemas), district religious affairs office, ECD partners, and ECCE teachers associations.

Apart from the issues of ECD district strategies and coordination bodies, it is important to note that in most districts ECD implementers tend to coordinate services at the level of delivery. In Sumbawa, for example, the teachers associa-tions include the IGTK (for kindergarten teachers), IGRA (for Islamic kindergar-ten teachers), and HIMPAUDI (for nonformal ECCE teachers). Cross-association meetings between teachers and other ECD partners, such as the ECD Forum and Women’s Group, take place every three months at the district level (the same types of teacher associations exist in Pacitan, also with quarterly meetings). The district education office and district religious affairs office direct the ECCE sector, which encompasses formal programs (mainly kindergartens and Islamic kindergartens) and nonformal programs (daycare centers and playgroups). The Ministry of Religious Affairs sets policy and budgets for Islamic kindergartens; the district religious affairs office conducts monitoring of the schools. The Ministry of Education and Culture and district education office are responsible for kindergartens, playgroups, daycare, and other types of ECCE services. In Kapuas

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as well, ECD implementers coordinate at the level of service delivery. ECCE teachers have regular monthly meetings held by the ECCE teacher association (Himpaudi or IGTKI). In addition, coordination meetings are held quarterly for all ECCE service providers, Women Group, and ECCE Supervisor Association.

In Manggarai Timur, the education sector leads the ECD policy development, and every village is required to at least have one type of ECCE service that cov-ers children from birth to age six years. In health and nutrition sectors, the focus is on children younger than five years of age, and parenting education services target parents with children from birth to age six years. Program implementers do not appear to meet regularly at the subdistrict or village level. Unlike the other districts studied, teacher associations do not seem to coordinate meetings for ECD implementers.

FinanceThere are some differences between districts in the ratings for the finance policy lever, but these tend not to be very large as shown in figure 4.4. Still, while three districts are rated as established (Kapuas, Manggarai Timur, and Pacitan), the other two are rated as emerging (Sukabumi and Sumbawa), in part because of differences in the use of funding criteria.

The ECD budget process in Kapuas appears to be transparent. Explicit criteria are used to decide ECD spending in the education, health, nutrition sectors, and the district government can accurately report ECD expenditures. The family planning and women empowerment agency and district social affairs office report expenditures for all beneficiaries, but do not report expenditures specifi-cally for ECD-aged children. The district planning and development agency, education office, health office, social affairs office, family planning and women

Figure 4.4 Ratings for Finance Policy Levers

Manggrai TimurPacitanSumbawa

1.0

1.5

2.0

2.5

3.0

3.5

4.0


Polic

y Le

ver 3

: fin

ance

R2 = 0.7033

Sukabumi Kapuas

Indonesia


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empowerment agency, and community empowerment and village governance office coordinate through joint planning sessions to share budgets. Budget plan-ning documents are submitted to local parliament for assessment and approvals. In 2013, 37 percent of total government expenditures went towards public edu-cation, but only 0.2 percent of public education funding is spent on ECCE. The district government makes monthly payments to ECCE staff at public and pri-vate facilities. In spite of this, the minimum compensation for ECCE teachers is only one-third of the minimum primary school teacher compensation. The pay scale for kindergarten teachers is higher than that of nonformal ECCE teachers. Overall, because public support for ECCE is limited, parents may be required to pay for tuition, uniform, meals, and materials.

In Manggarai Timur as well, the local government uses explicit criteria to determine funding allocations for ECD in the health and nutrition sectors, giving consideration to number of children covered, children’s characteristics such as gender, socioeconomic status, special needs, as well as geographical location for nutrition funding solely. For other sectors, explicit formulas tend not to be used. Sectoral ministries coordinate to determine their budgets for ECD and budget planning documents are submitted to local parliament for assessment and approvals. The local government can report public ECD expenditures across health, nutrition, and education sectors. In 2013, 38.6 percent of the total gov-ernment expenditures went towards public education, but as in Kapuas only 0.4 percent of public education funding is spent on ECCE. The family planning and women empowerment agency reports expenditures used to fund activities related to institutional strengthening, gender mainstreaming, and socialization of women and child protection activities but not specific to ECD-aged children. Similarly, the district social affairs office reports expenditures for all beneficiaries used for activities such as socialization and assistance. The local government makes monthly payments to ECCE staff in government and nongovernment facilities. Kindergarten teachers are compensated with the same minimum salary as primary school teachers. In addition, teachers in community-based centers such as toddler-family group, daycare, and other ECCE services receive incen-tives from the local government, but because of limited budget only teachers from a few centers received the incentive.

In Pacitan, Sumbawa, and Sukabumi, with the exception of early childhood nutrition funding, the local governments do not use explicit criteria or formulas to determine how funds for ECD services are allocated across sectors. For nutri-tion funding, consideration is given to number of children covered, location, and historical precedent. As in other districts, sectoral ministries coordinate to deter-mine budgets for ECD, and budget planning documents are submitted to local parliament for assessment and approvals. Public ECD expenditures in most cat-egories are reported in these three districts. In 2013, only 5 percent of total government expenditures in Pacitan went towards public education, a much lower proportion than elsewhere; for Sumbawa and Sukabumi the proportion is much higher (34 percent for Sumbawa). But in the three districts as in other

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districts, less than 1 percent of public education funding is spent on ECCE. ECCE staffs in government and nongovernment facilities receive monthly com-pensation from the local government. In Pacitan, kindergarten teachers are com-pensated with the same minimum salary as primary school teachers, with salaries depending on the grade level at appointment, and teachers in community-based ECCE centers and other ECCE services receive incentives from the local govern-ment. By contrast in Sumbawa, the minimum ECCE teacher compensation is only 10 percent of the minimum primary school teacher compensation. In many cases, parents have to contribute fees to ECCE centers, with fees potentially include tuition, desk fees, and fees for parent–teacher associations. In Sukabumi as well, ECCE teachers are compensated at far lower levels than primary school teachers. This difference in pay for ECCE teachers explains why Sumbawa and Sukabumi contribute to lower ratings for the policy lever.

Implementing Widely Policy Goal and Levers

As shown in table 4.3 and as depicted in figure 4.5, Pacitan is rated at a higher level than the other four districts in terms of policies and programs related to implementing widely. This is in part because the coverage of programs is higher in Pacitan, which is not too surprising since among the five districts Pacitan is located in the richest province. The assessment of equity in ECD programs and policies tends to yield the lowest ratings of the three policy levers in part because of large differences between groups and areas in program coverage, but it must be noted that this is due in part to imputations of national level data, given the lack of detailed data by group or areas within districts. In what follows, we discuss the findings for each of the three policy levers.

Table 4.3 Implementing Widely Policy Goal and Levers

Policy goal Levers

Implementing widely

Scope of programs

Coverage of programs Equity

Indonesia district

Kapuas 2 2 2 2


Pacitan 3 3 3 2

Sukabumi 2 3 2 2

Sumbawa 2 3 2 1

All five districts 2.2 2.6 2.2 1.6

Countries

Indonesia 2 3 2 2


Note: Each number indicates the level of development in early childhood development policy at the national level. “1”= latent, “2”= emerging, “3”= established, and “4” = advanced.

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Scope of ProgramsThe ratings for the scope of programs are slightly lower in Kapuas and Manggarai Timur than they are in Pacitan, Sukabumi, and Sumbawa, but overall quite a few programs are available in all five districts, at least in principle, even though there are differences between sectors. As an illustration, figure 4.6 displays the scope of programs available in Pacitan by sector and beneficiary group—this corre-sponding visualization is fairly similar for the other districts.

Programs are established in Pacitan (and the other districts) across all rel-evant sectors and beneficiary groups (see figure 4.7). Although the Pacitan district government has not yet issued policy related to HI-ECD (Taman Posyandu), programs are being implemented in line with the East Java Provincial Regulation No. 63/2011on HI-ECD. The District Health Office provides a wide range of health and nutrition interventions for pregnant women and their young children. Through Taman Posyandu, integrated ECD services are delivered by village health post, toddler family group or BKB, and ECCE. The District Education and Religious offices provide early learning opportunities for young children. In line with the regulation on inclusive education, the education office ensures the existence of one inclusive ECCE facility in every subdistrict at minimum. The District Social Office has estab-lished the Family Hope program, which provides conditional cash transfers to low-income families for accessing ECD services. The office also provides counselling services for children facing social problems. The District Civil Registration Office implements SILADES, a program through which com-munities in remote areas/villages directly register their newborns without going to district capital city. While it is commendable that a wide range of programs are available in Pacitan and the other districts, the scale of service delivery is also an important consideration, and as will be discussed in the

Figure 4.5 Ratings in Implementing Widely Policy Goal

Kapuas


1.0

1.5

2.0

2.5

3.0

3.5

4.0

0 2,000 4,000 6,000 8,000 10,000 12,000

GDP per capita, PPP (current international $)

R2 = 0.3939

Manggrai Timur

Indonesia


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Figure 4.6 Scope of Programs in Pacitan District

Parents/ Caregivers/Community

Dist. PlanningBoard

Dist.EducationOffice

Pregnant women: ChildBirth Insurance SchemeProgram, HIV screening

test, breastfeedinginitiative, Ferrous and

Vitamin A supplement,deficiency energy

prevention, ITNdistribution, maternaldepression program

Dist. HealthOffice

Dist. ReligiousOffice

Dist. FamilyPlanning and WomenEmpowermentBoard

Dist. CommunityEmpowerment andVillage GovernanceOffice

Dist. CivilRegistrationOffice

Dist. Social Office

ECD Partner

PregnantWomen

Coordinator in HI-ECD implementation and prepare district planning relate to ECD

Service delivery: (4−6): Kindergarten

Service delivery (0−4): Childcare, Playgroup Teachertraining on

ECD curricula

Well-infant/baby visit: height and weight measurement, growth monitoring

Early stimulation, detection, intervention of children younger than five years of age

Vitamin A, basic immunization, malnutrition prevention program

Health intervention in HI-ECD program (0−6):Taman Posyandu

Training for health worker (growth monitoring)

Service delivery (0−6): Koran Kindergarten (TPQ) and Sunday School

Service delivery (4−6):Islamic kindergarten (RA)

Integrated center for women and children (P2TP2A)

Child protection and parenting intervention in HI-ECDprogram (0−6): Taman Posyandu

Community empowerment intervention in HI-ECDprogram (0−6): POSPA BKB

Service delivery (0−5): Posyandu

Social assistance for temporary orphan housing (food cost)

Family Hope Program (Conditional Cash Transfer) to poor families with pregnant women orhaving ECD-aged children or having primary and secondary school-aged children

Social assistance and physical tools for severe disabled, including child

Advocacy and counseling program for children with social problem (ie.children with legal problem, neglected children, children as violence victim)

Kindergarten and Islamic kindergarten teacher association (IGTKI/IGRA), nonformal ECCEteacher association (HIMPAUDI): supporting local government policy and program on ECD

PNPM Mandiri:Supporting ECD

infrastrucrure(building)

Birth Registration:SILADES program

(3)

Parenting education program: Toddler-family group (Bina Keluarga Balita, BKB)

Incentive forPosyandu Cadre:15,000 IDR per

month

Monitoringevaluation

activity

Inclusive education program (2)

Education intervention in HI-ECD program (0−6): TamanPosyandu (1)

Teacher incentive:100,000 IDR per

teacher per month

Birth

Children

Age 2 Age 4 Age 6Teacher/Health

Worker

Note: ECCE = early childhood care and education; ECD = early childhood development; IDR = Indonesian rupiah; PNPM = Program Nasional Pemberdayaan Masyarakat (National Program for Community Empowerment).

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next chapter, coverage is at times low. In addition, programs tend to be more limited in scope in the areas of child and social protection. Antipoverty inter-ventions and programs targeted towards orphans and vulnerable children or children with special needs do not exist, for example.

Coverage of ProgramsAs shown in table 4.3 and figure 4.8, the ratings for the coverage of programs are the same for all districts except Pacitan which has a higher rating (established as opposed to emerging). This is not surprising since among the five districts Pacitan is located in the richest province. Information on coverage for a few specific ECD interventions is provided in table 4.4.

In Kapuas, Pacitan, and Sumbawa, the coverage of antenatal care and skilled delivery are greater than 90 percent, while in Manggarai Timur and Sukabumi, coverage rates are lower. In four of the five districts, immunization against diph-theria, pertussis, and tetanus (DPT) is near universal, but the rate is lower in Sukabumi. By contrast, the share of children younger than five years of age with suspected pneumonia who receive antibiotics is much lower, with the highest rate observed for Pacitan at 47.6 percent. Pacitan also has the highest coverage rates for vitamin A supplementation for children 6–59 months (at 93.5 percent), with Manggarai Timur having the lowest rate at 57.3 percent. In Kapuas, only a very small minority of children are exclusively breastfed, with the rates being less than half for Sukabami and higher for the other two districts. Gross enrollment in preprimary education is below one-third, except for Pacitan where it is at 60.3 percent—in general as many girls attend preschools as boys. The birth registration rate in Kapuas at 43.9 percent is much higher than in Manggarai Timur, but much lower than in Pacitan where special programs have been put in place. (Data were not available for the other districts.)

Figure 4.7 Ratings for Scope of Program Policy Lever

Indonesia

Kapuas


1.0

1.5

2.0

2.5

3.0

3.5

4.0


R2 = 0.2151

Manggrai Timur


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Table 4.4 Coverage of Selected Early Childhood Development Programs by District

KapuasManggarai

Timur Pacitan Sukabumi Sumbawa

Births attended by a skilled attendant 91.5 77.0 96.5 82.6 95.1

Pregnant women who attend at least four antenatal visits

90.7 83.0 91.9 83.9 92.8

One-year-old children immunized against DPT3

97.7 119.0a 102.4a 91.6 100.0

Children with suspected pneumonia getting antibiotics

0.8 22.8 47.6 36.2 —

Vitamin A supplementation, children 6–59 months

74.3 57.3 93.5 87.1 92.7

Exclusive breastfeeding until 6 months 4.0 78.1 82.1 41.0 76.3

Gross preprimary enrollment rate 23.6 24.0 60.3 23.7 31.8

Preprimary enrollment ratio of boys to girls 1.03 0.94 1.03 0.96 1.01

Birth registration rate 43.9 2.0 87.8 — —

Source: Health Office of Kapuas District (2013); Health Office of Manggarai Timur District (2013); Health, Education, and Population Registration Office of Pacitan District (2012), Health Office of District (2013), and Health Office of Sumbawa District (2013).Note: DPT = diphtheria, pertussis, and tetanus. — = not available.a. In Manggarai Timur district, 5,451 children younger than one year old received DPT3 immunization out of 4,559 children targeted (119 percent). Similarly in Pacitan district, 7,700 children younger than one year old received DPT3 immunization out of 7,518 children targeted (102.4 percent). These high rates of DPT3 immunization coverage in these two districts may be attributed to the inclusion of immunized children who resided in the neighborhood districts.

Figure 4.8 Ratings for Coverage of Programs Policy Lever

Indonesia

Kapuas

Pacitan

Sumbawa

1.0

1.5

2.0

2.5

3.0

3.5

4.0


R2 = 0.1605

Manggrai TimurSukabumi


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EquityThe ratings for equity are slightly higher in Kapuas, Pacitan, and Sukabumi, than in Manggarai Timur and Sumbawa, but overall all districts are rated low, at the latent or emerging level (see figure 4.9). This is in part because data are often not available at the district level on equity in the coverage of programs. For that reason, values at the national level were imputed, and since there is a lot of inequality in coverage at the national level between quintiles or by geographic area, this translates through in the imputation at the district level. But apart from differences in coverage rates between groups, additional information is used to assign ratings, including for the availability of instruction in local lan-guages, and the existence of policies for vuln,erable groups, for example to serve children with special needs or orphans and vulnerable children.

In Kapuas, the curriculum and teacher materials are not translated to pro-mote mother tongue instruction. While mother tongue instruction is not man-dated in Manggarai Timur, the local government encourages it, and at times the local language is used in order to make instructional materials easier to be understood. Yet, Bahasa Indonesian remains as the standard language. Pacitan has an inclusive education policy which guarantees the provision of ECCE ser-vices to children with special needs, and while mother tongue instruction is not mandated, it is encouraged and sometimes the local language is used in order to make the instructional materials more easily understood. In Sukabami, no mechanisms appear to currently exist to ensure access to services for children with special needs. Mother tongue instruction is not mandated but is sometimes used in preprimary education to facilitate learning. Finally, Sumbawa also does not have an inclusive education policy and does not guarantee ECCE services to children with special needs. Mother tongue instruction is again encouraged but not mandated.

Figure 4.9 Ratings for Equity Policy Lever

Indonesia

Kapuas

Manggrai Timur

PacitanSukabumi

Sumbawa

1.0

1.5

2.0

2.5

3.0

3.5

4.0


R2 = 0.9196


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Monitoring and Assuring Quality Policy Goal and Levers

As shown in table 4.5, with the exception of Kapuas that is rated as emerging, all districts are rated as established for the monitoring and quality policy goal. Ratings for data availability are the same (emerging) for all districts (See Figure 4.10), and the same is observed for quality standards, although there the rat-ings are higher (established). There are more differences between districts for the compliance with standards. In what follows, findings for each of the policy levers are provided.

Table 4.5 Benchmarking the Monitoring and Quality Policy Goals

Policy goal Levers

Monitoring and quality

Data availability

Quality standards


Indonesia district

Kapuas 2 2 3 2


Pacitan 3 2 3 3

Sukabumi 3 2 3 2

Sumbawa 3 2 3 3

All five districts 2.8 2 3 2.4

Countries

Indonesia 2.5 3 2.9 1.7


Note: Each number indicates the level of development in early childhood development policy at the national level. “1”= latent, “2”= emerging, “3”= established, and “4”= advanced.

Figure 4.10 Ratings for Monitoring and Assuring Quality Policy Goal

Indonesia

Kapuas

Manggrai TimurPacitan

SukabumiSumbawa

1.0

1.5

2.0

2.5

3.0

3.5

4.0


R2 = 0.11


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Data AvailabilityAll five districts have the same rating in terms of data availability. This is because in all five districts, limited administrative data are available on ECD programs and outcomes (see figure 4.11). Data are collected on young children’s enroll-ment in preschools and usage of health, nutrition, and some protection services. Data on children’s access to some ECD services by gender are also collected, but typically information is not available within districts by socioeconomic status, location, ethnicity, mother tongue, or special needs status. The national house-hold surveys are representative at the provincial level only and therefore cannot be used for district-level assessments. Inequalities in child development begin in the prenatal period and increase over time without necessary interventions. Good data are needed to implement correcting measures.

Indicators to measure physical, cognitive, language, and social development are also typically not collected. Tracking individual outcomes can indicate when extra services are necessary for children with developmental difficulties. One example of a comprehensive tracking system is found in Chile, under its new ECD policy, Chile Crece Contigo. The policy includes a bio-psychosocial devel-opment support program that tracks the development path of all children who are covered by the public health system (75 percent of Chile’s children). The health sector plays a central role, providing most of the services and screening, but the intervention allows for differentiated support to the most vulnerable children, tracking their development comprehensively and intervening with multisectoral services when necessary.

Figure 4.11 Ratings for Data Availability Policy Lever

Indonesia

Kapuas

Manggrai TimurPacitan

Sukabumi

1.0

1.5

2.0

2.5

3.0

3.5

4.0


R2 = 0.0315

Sumbawa


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Quality StandardsAs for data availability, all five districts have the same rating for quality standards (see figure 4.12). Learning standards for ECCE have been established nationally. In 2009, the Directorate General of the Ministry of Education and Culture estab-lished the early childhood education and development (ECED) Learning Standard through Ministerial Regulation no. 58/2009. The teacher-to-child ratio standards are as 1:6 for birth to two-year-olds; 1:10 for two- to five-year-olds; and 1:15 for five- to six-year-olds. The standards also include motor, cognitive, lan-guage, socioemotional, art, and religious/morality areas for children ages 0–72 months. The standards are evidence based and stem from ECED studies in Indonesia. However, mechanisms are not in place to enforce the standards, as will be discussed in the next chapter. In addition, there is no clear effort to ensure coherence and continuum between the preprimary and primary curricula. School supervisors are responsible for monitoring and evaluation of the learning process and for maintaining quality, but these activities are not formally regu-lated. As part of a World Bank project, the Directorate of Teachers and Educators in the Ministry is developing monitoring and evaluation tools and a manual for ECCE school supervisors. The manual and tools are expected to be formally adopted by the central government to help supervise ECCE centers.

The ministry has set infrastructure and construction requirements for ECCE facilities, including standards for functional hygienic facilities and potable water sources. However, no specific policy exists to inspect the quality of ECCE centers for construction and infrastructure, and registration and accreditation procedures are not in place for ECCE facilities. The policy on construction standards is cur-rently being reviewed and is expected to cover all ECCE facilities.

Standards for preservice qualifications are established for ECCE service pro-viders, again at the national level. The Ministry of Education and Culture has

Figure 4.12 Ratings for Quality Standards Policy Lever

Indonesia

Kapuas

Pacitan

Sukabumi

Sumbawa

R2 = 0.18481.0

1.5

2.0

2.5

3.0

3.5

4.0


Manggrai Timur


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established qualification standards for caregivers and ECCE teachers under Ministerial Regulation No. 16/2007. ECCE teachers (guru) for five- and six-year-olds are required to have a specialized tertiary degree in ECD or psychology. ECCE teacher assistants (guru pendamping) are required to have a diploma degree in kindergarten schooling or upper-secondary school completion with certified ECCE training. Caregivers (pengasuh) are required to have completed secondary school. The district education offices manage preservice and in-service teacher training. In-service training is mandatory and is regulated through ECCE teacher training manual by the directorate general of early childhood education. It consists of a tiered training program comprising 48 hours basic training, 64 hours medium learning, 80 hours advanced learning, and a fieldwork practicum. ECCE teachers are required to take a preservice fieldwork practicum. Thus, a total of about 200 hour preservice practicum (Tugas Mandiri) is mandated for ECCE teachers. Standards are also in place for health workers. For example, vil-lage midwives and officers from district health offices are required to complete training in ECD, and as is the case for ECCE centers, there are construction standards established for health centers and hospitals.

Compliance with StandardsMechanisms to track compliance with standards for ECCE services could be improved in all five districts, although Pacitan and Sumbawa are doing slightly better according to the ratings (see figure 4.13). As mentioned in the previous chapter, no policy for inspection of ECCE centers exists and compliance with construction standards is not monitored. Centers tend to comply with service delivery standards. For example, in Kapuas the average teacher-to-child ratio is 1:8, which is conducive to a strong learning environment. Some centers are

Figure 4.13 Ratings for Compliance with Standards Policy Lever

IndonesiaKapuas

Manggrai Timur PacitanSukabumiSumbawa

R2 = 0.22081.0

1.5

2.0

2.5

3.0

3.5

4.0



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opened only for a few hours per week, well below the international best practice standard of at least 15 hours per week.

There are some differences between districts in terms of compliance with regulation on the level of education required for ECCE teachers. In Kapuas, 974 of the 994 ECCE teachers have the required level of education. In Pacitan, among 2,510 ECCE professionals, 87 percent have completed upper-secondary school, a proportion slightly higher than in Sukabami (83 percent). In Sumbawa, the proportion is even higher at 92 percent (2,445 of 2,667 ECCE teachers). In Manggarai Timur, the proportion is however lower, with 98 of 180 nonformal ECCE teachers having the required level of schooling, but those who do not have the necessary formal qualifications receive in-service training from the district education office. Teachers without the required level of education receive in-service training from district education offices.

In general, when policies exist, the desired outcomes can be quite good, including in terms of program coverage. But the lack of policies on some impor-tant issues often correlates with poor outcomes, and simply having a policy may not be enough. This highlights the need to put in place regulatory and monitor-ing frameworks for all key ECD interventions.

Conclusion

In the context of substantial decentralization for ECD policies and programs in Indonesia, this chapter has provided results from the implementation of SABER-ECD tool in five illustrative districts. While on some dimensions the performance of the districts is similar, in other dimensions there are differences. Table 4.6 provides the ratings obtained by each of the five districts for the nine policy levers. On average, across all policy levers, Pacitan, the district located in the richest province, has the highest ratings (average rating of 2.6). Manggarai Timur, the district located in the poorest province, has the lowest ratings (aver-age rating of 2.0). However, for the other three districts, the average ratings do not follow the level of economic development of the provinces in which the districts are located. Of these three districts, Kapuas has the lowest average rating (value of 2.1), while it is in the richest of the three provinces. The aver-age rating for Sukabumi and Sumbawa is 2.3. With the notable exception of Kapuas, which seems to be underperforming, the ranking based on the average ratings for SABER-ECD policy levers is the same as the ranking based on the level of economic development of their province. Still, the association between both variables appears limited.

What are some of the broad policy recommendations that could be made on the basis of these results? Specific recommendations would typically require additional analysis. In terms of the enabling environment, given that districts are responsible for the implementation of ECD policies and programs, it would make sense for the districts that have not yet done so to adopt district-level multisectoral ECD strategies and to define a menu of essential services to be

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delivered through various entry points. In addition, again for the districts that have not yet done so, it would be advisable to establish a district-level institu-tional anchor to coordinate ECD service delivery across sectors as delineated in the presidential decree. At first, the focus could be on information sharing and devising ways to enhance coordination, but as the anchor evolves and develops its capacity, it could assume a more strategic role in guiding the establishment of a holistic ECD district policy.

For a number of interventions, it would make sense to mandate universal coverage, or at least greatly expand coverage. This is the case for birth registration, which should be free, and where Pacitan has done better than other districts thanks to innovative programs. Many programs have limited coverage, and the priority should be to ensure access for children facing disadvantage, including orphans and children with special needs. Preprimary education should be expanded as participation in quality ECCE programs has been linked to improved attention and learning outcomes, as well as higher completion rates and school attainment levels. While a number of health interventions have good coverage, this is less the case for social protection and child protection services. In some of the districts especially, breastfeeding should be encouraged among new mothers, as exclusive breastfeeding until six months can reduce infant mor-tality and promote healthy development. Improvements in immunization requirements would also help.

For expanding various programs, higher budget allocations will often be required, and at least in some districts, the pay of service providers such as ECCE personnel should be improved. In addition, while some districts use explicit criteria and formulas for allocations of funds for early childhood programs across

Table 4.6 Comparison of District Ratings


Policy goal Policy lever KapuasManggarai

Timur Pacitan Sukabumi Sumbawa


Legal framework

Coordination

Finance

Implementing widely

Scope of programs

Coverage

Equity


Data availability

Quality standards



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sectors, thereby ensuring more efficient and equitable allocation of resources, other districts have not yet adopted such practices.

On the data side, while good information is often available from administra-tive records and household surveys (including regular Demographic and Health Surveys) at the national and provincial level, this is not the case at the district level. Efforts are required here as well, including for tracking access to ECD programs and child-level outcomes in vulnerable groups. Many countries have developed simple tools to do so, such as child health and development passports. These types of data can help in identifying children in need of additional support. Monitoring compliance with quality standards—for construction as well as operation—through established accreditation procedures for ECCE facilities is also important. Resources need to be made available to preschool supervisors to properly monitor and support schools.

At district level, ECED supervisor (Penilik) is the one who, by Minister of State Apparatus and Bureaucracy Reform No. 14/2010, responsible for delivering quality assurance for ECED services. In most districts, however, the role of the supervisor in quality assurance does not work. It is therefore important for dis-trict as well as central government to revitalize the role of the supervisor in qual-ity assurance. This can be done through capacity building for the supervisor, the development of tools, such as monitoring and evaluation tool to support them in the delivery of their role in quality assurance and better institutional and organi-zational supports for supervisor.

Table 4.7 provides a summary of district-level policy options for improved implementation. While some of these options are easily accessible and can be put into place fairly quickly and at low cost; others, also critically important, will take more time and investment of resources. Therefore, the policy options are classi-fied into short- and medium-term options according to potentially required implementation timeframe.

Table 4.7 Summary of Policy Options to Improve ECD Implementation at the District Level



Use explicit criteria and formulas for allocations of funds for early childhood programs across sectors ensuring more efficient and equitable allocation of resources. Such practices should be adopted across districts.

Consider implementing a HI-ECD policy at the district level. As a mandatory legal framework, the policy will guide the sectors at district level to provide HI-ECD services for all children.

Improve collaboration between district offices to ensure a comprehensive HI-ECD system beyond the education sector. Change the view that ECED is not only the role of education sector between district offices. HI-ECD mea-sures the coordination within sectors and across institu-tions to deliver services effectively, including health and nutrition, as well as child and social protection sector.

Consider including the ECED sector into district annual educational development planning.


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Strengthen communication between sectors (district of-fices). This could be done during annual joint meetings hosted by District Development Planning Agency.

Increase budget allocation to expand various programs. In at least some districts, this will involve improving salaries of service providers such as ECCE personnel and health workers.

Establish a district-level institutional anchor or joint secretariat to coordinate ECD service delivery across sectors. At first, the focus could be on information sharing and devising ways to enhance coordination, but as the anchor evolves and develops its capacity, it could assume a more strategic role in guiding the establishment of a holistic ECD district policy, as well as sharing cost.

Encourage village participation in funding and provision of services. The issuance of Village Law No. 6/2014 provides broader opportunities for village governments to participate in funding and providing quality early childhood services through the village budget (Anggaran Dana Desa


Expand coverage of social protection and child protection services, which currently have lower coverage than health interventions. In some of the districts, breast-feeding should be encouraged to reduce infant mortal-ity and promote healthy development.

Mandate universal coverage, or at least greatly expand cov-erage. For example, initiate a free-fee birth registration policy and provide low-cost services for disadvantaged children (poor families, live in rural or border areas, vulnerable and special needs children).

Improve immunization requirements.


Track access to ECD programs and child-level outcomes in vulnerable groups. Many countries have devel-oped simple tools to do so, such as child health and development passports. These types of data can help in identifying children in need of additional support.

Establish a one-source-data collection system for consis-tent use among district offices. It will help the mapping of children and their needs at district level.

Provide fee-free in-service training for early childhood teachers. Broaden access and enhance quality of in-service training (Diklat Berjenjang) to improve the quality of teachers.

Establish provincial- and district-level task forces to strengthen the accreditation system. It is sometimes difficult to get the accreditation from national level since it takes effort on cost and time.

Improve compliance with quality standards—for construction as well as operation—through established accreditation procedures for ECCE facili-ties. Adequate resources need to be made available to preschool supervisors to properly monitor and support schools.

Note: ECCE = early childhood care and education; ECD = early childhood development; ECED = early childhood education and develop-ment; HI-ECD = Holistic Integrated-Early childhood development.

Table 4.7 Summary of Policy Options to Improve ECD Implementation at the District Level (continued)

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Abstract

One of the objectives of the Systems Approach for Better Education Results (SABER) initiative is to produce comparable policy data between countries. Is the performance of Indonesia on the SABER Early Childhood Development (ECD) policy goals and levers at the level that would be expected for the country’s level of economic development? To answer that question, it is necessary to document the relationship (or lack thereof) between ratings for various policy levers and goals and the level of economic development of countries, and next to locate where Indonesia stands with respect to that relationship. The objective of this chapter is to conduct this analysis using data from the implementation of SABER-ECD in 28 countries.

Introduction

One of the objectives of the SABER initiative is to produce comparable policy data between countries. While comparisons between Indonesia and a few other countries were provided in chapter 2 for some of indicators or ratings obtained for selected policy levers and goals, this was not done in a systematic way. In addition, these comparisons did not factor in (or control for) the level of devel-opment of countries. Using the data collected from the implementation of the SABER-ECD tool in 28 countries, this chapter provides an assessment of how well Indonesia is doing for each of the policy levers and goals in comparison to the expected level of performance of the country, given its level of economic development. In addition, the chapter provides a number of examples of best practice for each of the three policy goals of SABER-ECD.

The chapter is based on the analysis of SABER-ECD data collected for 28 countries: Albania, Armenia, Belize, Bulgaria, Colombia, The Gambia, Guinea,

C H A P T E R 5

SABER-ECD Ratings for Indonesia in Comparative PerspectiveAmina Denboba and Quentin Wodon

The authors are very grateful to Janice Heejin Kim for research assistance.

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94 SABER-ECD Ratings for Indonesia in Comparative Perspective


Table 5.1 Comparative Performance of Indonesia for SABER-ECD Goals and Levers

Goal 1: Enabling

environment

Goal 2: Implementing

widely

Goal 3: Ensuring quality

Lever 1: Legal

framework

Lever 2: Coordination mechanism

Lever 3: Finance

Indonesia 3 2 2.5 3 3 3

Average 2.1 2.4 2.1 2.4 1.9 2.1

Lever 4: Scope of

programs

Lever 5: Coverage of

programs

Lever 6: Equity in coverage

Lever 7: Data

availability

Lever 8: Quality

standards

Lever 9: Compliance with

standards

Indonesia 3 2 2 3 2.9 1.7

Average 2.5 2.6 2.3 2.1 2.5 1.6

Source: World Bank SABER-ECD Survey.Note: Each number indicates the level of development in early childhood development policy at the national level. “1” = latent, “2” = emerging, “3” = established, and “4” = advanced. Average indicates the average rating of 28 countries participated in the SABER-ECD Survey. SABER-ECD = Systems Approach for Better Education Results-Early Childhood Development.

Indonesia, Jamaica, Kyrgyz Republic, Malawi, Mauritius, Nepal, Nigeria, Samoa, Seychelles, Solomon Islands, Sri Lanka, Swaziland, Tajikistan, Tanzania, Togo, Tonga, Tuvalu, Uganda, Vanuatu, the Republic of Yemen, and Zanzibar. This sample includes low-income as well as middle-income countries. It turns out that in purchasing power parity (PPP)-adjusted US dollars, Indonesia is about at the midpoint of the sample of countries according to gross domestic product (GDP) per capita.

Table 5.1 provides the ratings for the various policy levers and goals obtained for Indonesia and for the full sample of countries on average. For two of the goals (establishing an enabling environment and ensuring quality), the performance of Indonesia is above that of the average for other countries where the tool has been implemented. For the third goal (implementing widely), Indonesia is performing less well. In terms of levers, Indonesia ranks above the average for seven levers and below for two (program coverage and equity), but these are particularly important levers in terms of services and interventions that actually reach house-holds. The question is whether for its level of development, Indonesia has good policies.

The structure of the chapter is as follows: It first provides a simple analysis of the relationship between level of economic development and SABER-ECD rat-ings. It then provides examples of best practice for each of the three policy goals. A conclusion follows.

Ratings and Levels of Development

How closely related are the ratings for SABER-ECD policy levers and goals with the level of development of countries as measured by GDP per capita in current international $ (purchasing power parity-adjusted)1 terms? Figure 5.1 as well as table 5.2 provide the answer. The figure provides simple scatter plots of the

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SABER-ECD Ratings for Indonesia in Comparative Perspective 95


a. Establishing an enabling environment

Indonesia

R2 = 0.28040

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

0 5,000 10,000 15,000 20,000 25,000


Figure 5.1 Ratings in Policy Goals and Level of Development

b. Implementing widely

Indonesia

R2 = 0.41650

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

0 5,000 10,000 15,000 20,000 25,000


c. Monitoring and assuring quality

Indonesia

R2 = 0.3460

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

0 5,000 10,000 15,000 20,000 25,000


Source: World Bank SABER-ECD Survey.Note: GDP = gross domestic product; PPP = purchasing power parity; SABER-ECD = Systems Approach for Better Education Results-Early Childhood Development.

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Table 5.2 Relation between Policy Goals, Policy Levers, and Level of Development

Policy goals Policy levers R2

1. Establishing an enabling environment 0.280 Legal framework 0.092

Intersectoral coordination 0.015

Finance 0.473

2. Implementing widely 0.417 Scope of programs 0.309

Coverage 0.461

Equity 0.279

3. Monitoring and assuring quality 0.346 Data availability 0.260

Quality standards 0.158

Compliance with standards 0.283

Highest R2 Finance 0.473

Lowest R2 Intersectoral coordination 0.015

Source: World Bank SABER-ECD Survey.Note: SABER-ECD = Systems Approach for Better Education Results-Early Childhood Development.

ratings of countries for policy goals on the vertical axis as a function of the level of economic development on the horizontal axis (similar figures are provided in annex at the level of policy levers). Table 5.2 provides the value of the R2 of the regression line (or curve) traced through the scatter plots. A higher value for the

R2, which takes a value between 0 and 100 percent, denotes a closer association between the policy lever or goal rating and the level of development of countries.

Figure 5.1 (as well as the figures in annex 5A for policy goals) and table 5.2 suggest a strong correlation between ratings for finance (R2 value of 0.473) and the rating for the coverage of programs (R2 value of 0.461) and the level of economic development. This is not surprising since ensuring high coverage for key ECD interventions requires funding, and funding is more easily available among countries with higher levels of economic development. The correla-tions are smaller (R2 values between 0.100 and 0.350) for the scope of pro-grams and the equity in coverage, as well as the three policy levers for ensuring quality. The correlations are virtually zero (R2 values below 0.100) for the last two policy levers: Legal framework and intersectoral coordination (R2 val-ues well below 0.05). In other words, countries at lower levels of economic development are rated, as well as countries at higher levels of economic devel-opment, for these two policy levers. As a result, the correlation between the first policy goal and economic development is the weakest, while the correla-tion between the second goal and economic development is the strongest.

In the various figures, the position of Indonesia is indicated by a large red dot. As mentioned earlier, for the first and third goals, Indonesia is above the average, and also above the expected level, given its GDP per capita. But for the second

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goal, which focuses on actual delivery of programs, Indonesia is performing below the average level and below the expected level for the country, given its GDP per capita.

Examples of International Best Practice

What are some examples of countries that have been performing very well in the various dimensions and that could provide inspiration for policy in Indonesia? This section provides illustrations of selected best practice policies for all three policy goals from around the world, including a few countries where the SABER-ECD tool has been applied (Jamaica and Mauritius).

Establishing an Enabling EnvironmentIn the case of the first policy goal—establishing an enabling environment, at least four experiences can be mentioned. First, in Chile, a holistic ECD system is embedded in the law, guaranteeing differentiated support for the poorest 40 percent of children. In 2005, the Government of Chile embarked on an ambi-tious path to improve ECD, which culminated in September 2009 with the Chile Crece Contigo (CCC, Chile Grows with you) Law No. 20,379. CCC is an intersectoral and multidisciplinary approach to achieve high-quality ECD by protecting children from conception onwards with relevant and timely services that provide opportunities for early stimulation and development. A core ele-ment of the system is that it provides differentiated support and guarantees for boys and girls from the poorest 40 percent of households, including free access to preprimary school. Furthermore, the CCC mandates provision of services for orphans and vulnerable children and children with special needs. The creation and implementation of the CCC has been accomplished through a multisectoral, highly synergetic approach at all levels of government. At the central level, the Presidential Council is responsible for the development, planning, and budgeting of the program. At each of the national, regional, provincial, and local levels, there are institutional bodies tasked with supervision and support, operative action, as well as development, planning, and budgeting for each respective level. Other pertinent aspects of the Chilean Social System is 18 weeks of paid mater-nity leave and additional 4 days of paid leave for fathers, both of which are high by Latin American standards. The legal framework includes mandatory iron for-tification of food staples and salt iodization and promotion of the International Code of Marketing of Break Milk Substitute.

Second, in Jamaica in 2003, the government established the Early Childhood Commission (ECC) as an official agency to govern the administration of ECD in Jamaica (Early Childhood Commission Act). Operating under the Ministry of Education, the ECC is responsible for advising the Ministry of Education on ECD policy matters. It assists in the preparation as well as monitoring and evaluation of ECD plans and programs, acts as a coordinating agency to streamline ECD activities, manages the national ECD budget, and supervises and regulates early

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childhood institutions. The ECC includes a governance arm comprising the offi-cially appointed Executive Director, a Board of Commissioners, and seven sub-committees representing governmental and nongovernmental organizations. It also has an operational arm that provides support to the board and subcommit-tees. The ECC is designed with representation from all relevant sectors, including education, health, local government and community development, labor, finance, protection, and planning. Each ministry or government agency nominates a rep-resentative to serve on the Board of Commissioners. The seven subcommittees which provide technical support to the ECC board comprise 50 governmental and nongovernmental agencies. Furthermore, the newly established National Parenting Support Commission creates links between Jamaican parents and the Government of Jamaica. In 2012, the Ministry of Education introduced the National Parenting Support Policy. The government recognized that parents should serve an important role to promote and coordinate organizational efforts and resources for positive parenting practices. The National Parenting Support Commission Act further established an official coordinating body to ensure effec-tive streamlining of government activities related to parenting.

Third, in Australia a participatory approach was used to achieve universal prep-rimary education and develop the ECD strategy, with the strategy now embedded in a strong legal framework. The Council of Australian Governments created the National Partnership Agreement on Early Childhood Education, which commits the Commonwealth and State and Territory Governments to ensure that all chil-dren have access to a quality early childhood education program in the year pre-ceding formal schooling by 2013. The program is required to be delivered by a four-year university-trained early childhood teacher and be provided for a mini-mum of 15 hours a week, 40 weeks per year. Developed under the auspices of the Council of Australian Governments in 2009, Investing in the Early Years—A National Early Childhood Development Strategy is a joint effort to ensure that by 2020 all children have the best start in life to create a better future for them and for the nation. The strategy is a comprehensive approach to ECD that focuses on a child’s life cycle, across the four interrelated dimensions of ECD, from the pre-natal period to age eight. An important factor for emphasis in Australia’s establish-ment of a comprehensive ECD system has been the effective participation, cooperation, and policy development across all levels of government. The strategy acknowledges that families, community, organizations, workplace, and govern-ment all play critical roles in shaping children’s development and thus requires an effective ECD system with sufficient capacity and stakeholder synergy.

Fourth, related to financing, Mauritius has developed a conditional cash transfer program to increase preprimary enrollment. To encourage parents to enroll their children, the government provides all families with financial support contingent upon the child attending the final year of preprimary school (age four years in Mauritius). The transfer amounts to $6 per month and has helped achieve an 85 percent enrollment rate in preprimary school for children ages three to five years in Mauritius. Provision is largely through nonstate centers (17 percent of all pre-

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schools are state managed), but the design and enforcement of quality control mechanisms has remained central to government policy efforts.

Implementing WidelyFor the second policy goal—implementing widely, the experiences of France and Sweden can be considered as best practice. Early childhood strategies in France aim to (1) increase childcare facilities and support; (2) increase benefits to pro-vide partial cover of the cost of child care by registered and accredited child minders; and (3) provide generous paid parental leave for parents who withdraw from the labor market. Publicly funded early childhood education (ECE) is well established and has a long history in France. Since the 1980s, ECE is the embed-ded under the auspices of the Ministry of Education. Children have a legal right to a place in a preschool from the age of three years. France has one of the high-est levels of publicly funded universal ECE provision amongst the EU countries for children ages three to five years. France invests considerably in childcare and education services in the years preceding formal school entry and has achieved remarkable success in terms of providing equal opportunities for children. The ecole maternelle is the dominant institutional form of ECE provision for children ages three years to school entry age, providing a full-day service throughout the school year. Alongside the ecoles maternelles, there are a number of other forms of services outside the education system, particularly for children younger than three years of age, administered under the joint responsibility of the Ministry of Employment, Social Cohesion and Housing, and the Ministry of Health and Solidarity. Publicly subsidized centre-based services include childcare centers (etablissements d’accueil regulier), parent cooperatives (etablissements a gestion parentale), multicare (multi-acceuil), and ‘kindergartens’ (jardins d’enfants) pro-viding flexible childcare services. Family daycare (Assistance maternelle) and fam-ily crèche (service d’accueil familial) are other forms of childcare provision for children under three. Furthermore, a number of other innovative services have been established with the aim to provide equitable access in rural and urban areas, including mobile services (services itinerants) and open door services (lieux d’accueil enfants parents).

Preschool educators (professeurs des ecoles) are generally trained at the same level and in the same training institutions as primary teachers, and caregivers within the social welfare system are primarily trained in the paramedical and health care domain. France provides generous family benefits allowing parents to choose the type of childcare facility they think best for their child and to reduce their professional activities in order to devote themselves to their child’s education. The Prestation d’Accueil du Jeune Enfant was introduced as a unified early childhood benefit system through the Caisses d’Allocation Familiale and includes monthly benefits from the seventh month of pregnancy until the child reaches age three. This benefit system is correlated with the child’s health care, thus child medical visits are required in order for the parents to be able to receive any benefit.

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In Sweden, young children benefit from a continuum of ECD services from birth to age six years. A unique and effective feature of this system is the multi-tude of options from which parents can choose. High-quality early childhood education is a legal right for all children. The three differentiated education interventions are preschool; family daycare homes; and, open preschools. Preschool, which operates year-round and provides a minimum of 525 hours of schooling, accommodates 15–20 students per class and accounts for the majority of children enrolled in ECE, including 92.7 percent of four-year-olds, 93 percent of five-year-olds, and 95.1 percent of six-year-olds. Family daycare homes, which are registered providers, are available to children ages 1–12 years. Approximately 4.3 percent of one- to five-year-olds attend, the larger portion of whom being located in rural areas. Open preschools service children ages one to seven years and actively involve the parent in the classroom. Health care services are free of charge for all pregnant mothers and children ages five years and younger. Services are mostly provided through maternal care centers and childcare centers and include pre- and postnatal care, routine health check-ups, hearing, sight, and other developmental screening. In addition, children receive free immunizations and dental health services. Coverage levels are near universal. Sweden’s ECD system achieves high-level equity, including full integration of children with dis-abilities and special needs. There is very little disparity in terms of access to ECD services by socioeconomic status, or by rural and urban localities, because of the free provision of services and the diversity of services offered.

Monitoring and Assuring QualityFor the third policy goal—monitoring and assuring quality—the experiences of New Zealand, Sweden, and Jamaica can be considered as best practice. The gov-ernment of New Zealand has recognized that the establishment of an effective ECD system requires extensive information on both the current state of child development in the country, as well as the establishment of standard measures to guide a child’s development. Most ECD-related interventions have devised frameworks to monitor and evaluate the impact and efficacy of interventions. As such, the government of New Zealand has invested heavily in the development of quality assurance frameworks and mechanisms to ensure ECD services effec-tively contribute to the development of children.

In the education sector, the integration of childcare services under the auspices of the Ministry of Education has been a crucial step for the development of quality early childhood care and education (ECCE) services. As a result of this integration, New Zealand is one of the first countries in the world to develop an innovative national early childhood education curriculum—The New Zealand Curriculum for English medium (NZC) and Te Marautange o Aotearoa for Maori medium (TMoA)—covering the entire age range from birth to five years. National Standards have been established to set the direction for teaching and learning in New Zealand schools, providing teachers with clear learning goals, guidance and information

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about students’ progress as they develop local curriculum and engaging contexts for the learning needs of their students. The ministry has further developed a strategic framework for generating good information about the implementation and out-comes of National Standards: the Ministry’s Pathways to the Future: Nga Huauahi Arataki, a 10-Year Strategic Plan for Early Childhood Education, sets improving quality as one of its main goals. Innovative approaches have been developed to assess children’s experiences and for teachers’ self-evaluation. The Ministry of Education considers the health, safety, and well-being of children in early childhood education services of utmost importance. The Education Regulations 2008 set out a range of requirements to which all ECE must adhere. This affected health and safety issues, staffing (ratios and qualifications), resources, facilities, and program delivery. The framework will draw from a range of different and complementary information sources, which will contribute to ministry decision making on ongoing implementation and support for the standards. The ministry has also undertaken numerous internal and external reviews of the ECE sector, which have been valu-able tools for informing policy. The integration has resulted in substantial increase of quality assurance between different types of ECCE services.

Throughout the life of Well Child Services, the government and the Ministry of Health have undertaken numerous reviews as part of their ongoing commitment to child health. The most recent was completed in 2010, and restructured many aspects of Well Child Services. One noteworthy change is the development of an evidence-based quality framework that works to ensure the program consistently achieves positive outcomes for all participating children and their families. A National Immunization Register records immunization events. In addition to specific research exercises that pertain to individual inter-ventions or sectors, ongoing endeavors are being undertaken to contribute to the wealth of knowledge of childhood development in New Zealand. These activities help inform policy makers, intervention operators, and communities and families. Led by the University of Auckland, and with financial contributions from mul-tiple government agencies, Growing up in New Zealand is a longitudinal study of children and families that follows a group of 7,000 children from the time they were born until they become adults. This is the first such study of its kind in New Zealand. The objective is to gain a better understanding of raising happy, healthy children, and, ultimately, to use this information to make more informed decisions that will improve the lives of all New Zealand children. It will be a number of years before its yields valuable information. The Ministry of Social Development (MoSD) consults with social agencies within the health, care and support, education, economic security, safety, civil and political rights, justice, cultural identity, social connectedness, and environment domains to produce Publications of Children and Young People: Indicators of Wellbeing in New Zealand. The second report was realized in 2008 and provides insight on the status of New Zealand children and young people. The NSU monitors the qual-ity of screening programs and works with expert groups and consumers to ensure

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that each screening program is based on the latest evidence and meets high standards. All providers are required to meet the professional, ethical and legal standards set by the UNHSPIP National Policy and Quality Standards.

In Sweden, an articulated curriculum, central monitoring, and quality assur-ance framework help improve local service delivery. ECD policies, objectives, and overall framework are set at the central level. Local governments are empowered to operate interventions in response to local demands and character-istics, thus providing services that are more context specific. Depending on the intervention, quality assurance mechanisms can take different forms and, in some instances, a multipronged approach is suitable. This is best evidenced through the preschool system where the Swedish Schools Inspectorate ensures compliance by conducting inspections of facilities to oversee and examine the quality of schools, while the National Agency for Education is responsible for facilitating and ensuring proper use of state funding and grants. In July 2011, Sweden adopted a revised curriculum. The main enhancement is the better articulation of the pedagogical tasks of the preschool system by clarifying the goals for lan-guage and communication, mathematics, natural science, and technology. The centers are autonomous to evolve their own local curricula and pedagogical methods from the principles outlined in the state curriculum. The National Agency for Education publishes supporting material and general guidelines with comments for guidance and supervision. In conjunction with the preschool sys-tem, the Universal Health Care System schedule presents a systematic approach to checkups, child evaluations, and interventions to ensure the needs of all young children are monitored and met across the four interrelated dimensions of ECD.

Jamaica has established standards and compliance mechanisms to assure qual-ity in early childhood institutions. The Early Childhood Commission (ECC) was established by an Act of Parliament, the Early Childhood Commission Act, in 2003. The Commission has the responsibility to ensure the integrated and coor-dinated delivery of early childhood programs and services. Through its varying activities, the ECC will guide the holistic development of children, including physical, cognitive, social, and emotional development. The Commission has a range of legislated functions, one of which indicates direct responsibility to super-vise and regulate early childhood institutions.

Standards for the operation, management, and administration of early child-hood institutions are in place. In Jamaican law, there are two types of standards: those transmitted by an Act or Regulations and which therefore carry legal con-sequences and those that serve to improve practice voluntarily and are not legally binding. For practical purposes, quality standards for early childhood institutions include both sets of standards, with clear indications of those stan-dards that are legally binding. To improve the quality of services provided by early childhood institutions, the ECC has developed a range of robust opera-tional quality standards for early childhood institutions. The Act and Regulations, which together comprise the legal requirements, specify the minimum levels of practice below which institutions will not be registered or allowed to operate.

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The standards that are not legally binding define best practices for early childhood institutions and serve to encourage institutions to raise their level of practice above minimum requirements. While early childhood institutions are encouraged to achieve the highest possible standards to ensure the best out-comes for children, the legally binding standards guarantee that minimum stan-dards are met.

Inspection and registration frameworks are in place. Inspection of early child-hood institutions is the procedure designated under the Early Childhood Act for ensuring that operators comply with the minimum acceptable standards of practice. The ECC is required to inspect each early childhood institution twice annually. It is a requirement of registration that the registered operator cooper-ates with the ECC’s inspection process. The “registered operator” is defined as the person required to apply for registration of an early childhood institution and may be an individual or a group. In deciding on the suitability of an early child-hood institution for registration under the Early Childhood Act, the ECC will, based on information obtained at inspection visits, determine whether or not an early childhood institution meets and complies with the Act and Regulations. Where existing provision falls short of the legal requirements, and the shortfall does not present a real and present danger to children, a permit to operate until full requirements are met will be granted, with time scales for institutions to meet requirements. The ECC encourages the promotion of the highest standards of practice by monitoring not only the minimum requirements at inspection visits but also those standards that are not legally binding.

Conclusion

The SABER initiative aims to produce comparable policy data between countries on policies implemented in various domains. In the case of SABER-ECD, data have been collected in 28 countries. This chapter has provided an assessment of how well Indonesia is doing for each of the nine policy levers and three policy goals of SABER-ECD in comparison to the expected level of performance of the country computed from the multicountry dataset, given Indonesia’s level of eco-nomic development. In addition, the chapter provided a number of examples of best practice policies implemented by countries for each of the three policy goals of SABER-ECD.

Overall, for two of the SABER-ECD goals (establishing an enabling environ-ment and ensuring quality), the performance of Indonesia is above that of the average for other countries where the tool has been implemented and also above the expected level of performance of the country, given its level of GDP per capita. But for the third goal (implementing widely), Indonesia is perform-ing less well than it should. This is important because at the end of the game what matters most for ECD is that essential interventions indeed reach young children.

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Note

1. GDP per capita based on purchasing power parity (PPP). PPP GDP is gross domestic product converted to international dollars using purchasing power parity rates. An international dollar has the same purchasing power over GDP as the U.S. dollar has in the United States.

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Annex 5A: Ratings and Level of Economic Development for Policy Goals

Figure A5.1 Ratings in Policy Levers and Level of Development


a. Legal framework

Indonesia

R2 = 0.09210

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

0 5,000 10,000 15,000 20,000 25,000GDP per capita, PPP (current international $)

b. Intersectoral coordination

Indonesia

R2 = 0.0150

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


c. Finance

Indonesia

R2 = 0.47340

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


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Figure A5.1 Ratings in Policy Levers and Level of Development (continued)


d. Scope of program

Indonesia

R2 = 0.30880

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


e. Coverage

Indonesia

R2 = 0.46080.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


f. Equity

Indonesia

R2 = 0.27930.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


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Figure A5.1 Ratings in Policy Levers and Level of Development (continued)


g. Data availability

Indonesia

R2 = 0.26020.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


h. Quality standards

Indonesia

R2 = 0.15790.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0

0 5,000 10,000 15,000 20,000 25,000


i. Compliance with standards

R2= 0.28340.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

4.0


Indonesia

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http://dx.doi.org/10.1596/978-1-4648-0646-9


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http://dx.doi.org/10.1596/978-1-4648-0646-9

Since the early 2000s, Indonesia has taken a number of steps to prioritize early childhood education and development (ECED)—ranging from its inclusion in the National Education

System Law No. 20 in 2003 to a Presidential Declaration on Holistic and Integrated ECED and the launch of the country’s fi rst-ever ECED Census in 2011. These policy milestones have occurred in parallel with sustained progress on outcomes included in the Millennium Development Goals, for issues including child malnutrition, child mortality, and universal basic education. Additional progress could be achieved by strengthening ECD policies and programs further.

Early Childhood Education and Development in Indonesia: An Assessment of Policies Using SABER presents fi ndings from an assessment of ECED policies and programs in Indonesia using two World Bank tools: the ECD module of the Systems Approach for Better Education Results (SABER) and the Stepping Up ECD guide on essential interventions for investing in young children. Results from the application of both tools to Indonesia are used to suggest a number of short- and medium-term policy options to strengthen the Indonesian ECED system.

ISBN 978-1-4648-0646-9

SKU 210646

Official PDF , 143 pages

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Transcript of Official PDF , 143 pages